TY - JOUR
T1 - Determinants of low health-related quality of life in patients with myelodysplastic syndromes
T2 - EUMDS Registry study
AU - Stojkov, Igor
AU - Conrads-Frank, Annette
AU - Rochau, Ursula
AU - Arvandi, Marjan
AU - Koinig, Karin A.
AU - Schomaker, Michael
AU - Mittelman, Moshe
AU - Fenaux, Pierre
AU - Bowen, David
AU - Sanz, Guillermo F.
AU - Malcovati, Luca
AU - Langemeijer, Saskia
AU - Germing, Ulrich
AU - Madry, Krzysztof
AU - Guerci-Bresler, Agnès
AU - Culligan, Dominic J.
AU - Kotsianidis, Ioannis
AU - Sanhes, Laurence
AU - Mills, Juliet
AU - Puntscher, Sibylle
AU - Schmid, Daniela
AU - van Marrewijk, Corine
AU - Smith, Alexandra
AU - Efficace, Fabio
AU - de Witte, Theo
AU - Stauder, Reinhard
AU - Siebert, Uwe
N1 - Publisher Copyright:
© 2023 by The American Society of Hematology.
PY - 2023/6
Y1 - 2023/6
N2 - Patients with myelodysplastic syndromes (MDS) frequently experience a significant symptom burden, which reduces health-related quality of life (HRQoL). We aimed to identify determinants of low HRQoL in patients recently diagnosed with MDS, for guiding early intervention strategies. We evaluated longitudinal data in 2205 patients with MDS during their first year after diagnosis. Median values of EQ-5D 3-level (EQ-5D-3L) index (0.78) and visual analog scale (VAS) score (0.70) were used as thresholds for low HRQoL. In addition, the 5 dimensions of EQ-5D-3L were analyzed for impairments (any level vs “no problem” category). After multiple imputation of missing values, we used generalized estimating equations (GEE) to estimate odds ratios (OR) for univariable determinant screening (P < .15), and to subsequently derive multivariable models for low HRQoL with 95% confidence intervals (CI). Multivariable GEE analysis showed the following independent determinants (OR, 95% CI) for low EQ-5D index: increased age (60-75 years: 1.33, 1.01-1.75; >75: 1.84, 1.39-2.45), female sex (1.70, 1.43-2.03), high serum ferritin level (≥1000 vs ≤300 μg/L: 1.41, 1.06-1.87), comorbidity burden (per unit: 1.11, 1.02-1.20), and reduced Karnofsky performance status (KPS, per 10 units: 0.62, 0.58-0.67). For low VAS score, additional determinants were transfusion dependence (1.53, 1.03-2.29), low hemoglobin <10 g/dL (1.34, 1.12-1.61), and high body mass index (≥30 vs 23-29.9 kg/m2: 1.26, 1.02-1.57). Sex, KPS, comorbidity burden, hemoglobin count, and transfusion burden were determinants for all EQ-5D dimensions. Low HRQoL is determined by multiple factors, which should be considered in the management and shared decision making of patients with MDS.
AB - Patients with myelodysplastic syndromes (MDS) frequently experience a significant symptom burden, which reduces health-related quality of life (HRQoL). We aimed to identify determinants of low HRQoL in patients recently diagnosed with MDS, for guiding early intervention strategies. We evaluated longitudinal data in 2205 patients with MDS during their first year after diagnosis. Median values of EQ-5D 3-level (EQ-5D-3L) index (0.78) and visual analog scale (VAS) score (0.70) were used as thresholds for low HRQoL. In addition, the 5 dimensions of EQ-5D-3L were analyzed for impairments (any level vs “no problem” category). After multiple imputation of missing values, we used generalized estimating equations (GEE) to estimate odds ratios (OR) for univariable determinant screening (P < .15), and to subsequently derive multivariable models for low HRQoL with 95% confidence intervals (CI). Multivariable GEE analysis showed the following independent determinants (OR, 95% CI) for low EQ-5D index: increased age (60-75 years: 1.33, 1.01-1.75; >75: 1.84, 1.39-2.45), female sex (1.70, 1.43-2.03), high serum ferritin level (≥1000 vs ≤300 μg/L: 1.41, 1.06-1.87), comorbidity burden (per unit: 1.11, 1.02-1.20), and reduced Karnofsky performance status (KPS, per 10 units: 0.62, 0.58-0.67). For low VAS score, additional determinants were transfusion dependence (1.53, 1.03-2.29), low hemoglobin <10 g/dL (1.34, 1.12-1.61), and high body mass index (≥30 vs 23-29.9 kg/m2: 1.26, 1.02-1.57). Sex, KPS, comorbidity burden, hemoglobin count, and transfusion burden were determinants for all EQ-5D dimensions. Low HRQoL is determined by multiple factors, which should be considered in the management and shared decision making of patients with MDS.
UR - http://www.scopus.com/inward/record.url?scp=85164957462&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2022008360
DO - 10.1182/bloodadvances.2022008360
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C2 - 36607832
AN - SCOPUS:85164957462
SN - 2473-9529
VL - 7
SP - 2772
EP - 2783
JO - Blood advances
JF - Blood advances
IS - 12
ER -