Differences in community and academic practice patterns for newly diagnosed myelodysplastic syndromes (MDS) patients

Daniel F. Pease, Julie A. Ross, Jenny N. Poynter, Phuong L. Nguyen, Betsy Hirsch, Adina Cioc, Michelle A. Roesler, Erica D. Warlick

Research output: Contribution to journalArticle

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Abstract

Purpose: The heterogeneous nature of myelodysplastic syndromes (MDS) complicates therapeutic decision making, particularly for newly diagnosed disease. Factors impacting the treatment plan in this early period of disease course are poorly defined. This study determines whether therapeutic choices for newly diagnosed MDS are associated with location of treatment (community or academic), prognostic risk category, and patient age. Methods: The adults in Minnesota with myelodysplastic syndromes (AIMMS) database was utilized in this statewide, prospective population-based study conducted by the University of Minnesota (UMN), Mayo Clinic, and Minnesota Department of Health. Adult (age 20+ years) cases of MDS newly diagnosed starting in April 2010 were invited to participate. This analysis includes patients enrolled during the first study year with 1-year follow-up data. Treatment choices (supportive, active, and transplant) were stratified by the international prognostic scoring system (IPSS) and the revised-IPSS (IPSS-R), then separated into groups by location of care and age (<65 or 65+ years). Academic-based care was any contact with the UMN and Mayo Clinic; community-based care was all other clinical sites. Results: Stratification by IPSS and IPSS-R showed supportive care decreased and active care increased with advancing risk categories (. p<. 0.0001). Comparing treatment setting, community-based care had 77% supportive and 23% active treatment; academic-based care was 36% supportive, 41% active, and 23% transplant (. p<. 0.0001). By age groups, patients <65 years with intermediate, high, or very high risk disease by IPSS-R received 97% active care/transplant, compared to only 52% of patients age 65+. Conclusions: Younger patients and those treated at academic centers had a more aggressive treatment approach. Whether these treatment differences convey improved disease control and mortality, and therefore should be extended more frequently to older and community-based patients, is the subject of ongoing prospective study.

Original languageEnglish (US)
Pages (from-to)222-228
Number of pages7
JournalCancer Epidemiology
Volume39
Issue number2
DOIs
StatePublished - Apr 1 2015

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Myelodysplastic Syndromes
Therapeutics
Transplants
Decision Making
Age Groups
Databases
Prospective Studies
Mortality
Health

Keywords

  • Bone marrow transplantation
  • Drug therapy
  • Hematologic malignancies
  • Myelodysplastic syndromes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Epidemiology

Cite this

Pease, D. F., Ross, J. A., Poynter, J. N., Nguyen, P. L., Hirsch, B., Cioc, A., ... Warlick, E. D. (2015). Differences in community and academic practice patterns for newly diagnosed myelodysplastic syndromes (MDS) patients. Cancer Epidemiology, 39(2), 222-228. https://doi.org/10.1016/j.canep.2015.01.006

Differences in community and academic practice patterns for newly diagnosed myelodysplastic syndromes (MDS) patients. / Pease, Daniel F.; Ross, Julie A.; Poynter, Jenny N.; Nguyen, Phuong L.; Hirsch, Betsy; Cioc, Adina; Roesler, Michelle A.; Warlick, Erica D.

In: Cancer Epidemiology, Vol. 39, No. 2, 01.04.2015, p. 222-228.

Research output: Contribution to journalArticle

Pease, DF, Ross, JA, Poynter, JN, Nguyen, PL, Hirsch, B, Cioc, A, Roesler, MA & Warlick, ED 2015, 'Differences in community and academic practice patterns for newly diagnosed myelodysplastic syndromes (MDS) patients', Cancer Epidemiology, vol. 39, no. 2, pp. 222-228. https://doi.org/10.1016/j.canep.2015.01.006
Pease, Daniel F. ; Ross, Julie A. ; Poynter, Jenny N. ; Nguyen, Phuong L. ; Hirsch, Betsy ; Cioc, Adina ; Roesler, Michelle A. ; Warlick, Erica D. / Differences in community and academic practice patterns for newly diagnosed myelodysplastic syndromes (MDS) patients. In: Cancer Epidemiology. 2015 ; Vol. 39, No. 2. pp. 222-228.
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