ArticleJournal of blood medicine2026
Impact of Transfusion Dependence on Clinical and Economic Burden in Patients with Lower-Risk Myelodysplastic Syndromes: A 28-Year Retrospective Study.
Article in Journal of blood medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Myelodysplastic syndromes comprise a diverse group of hematopoietic stem-cell malignancies characterized by ineffective hematopoiesis, cytopenia, and increased risk of acute myeloid leukemia. Anemia is a common manifestation of lower-risk myelodysplastic syndrome (LR-MDS) and often necessitates red blood cell (RBC) transfusions, although reliance on transfusions is associated with adverse outcomes and substantial burden. This 28-year, single-center, retrospective study aimed to assess the burden of RBC transfusion-dependence (RBC-TD) in terms of healthcare resource utilization (HCRU), medical costs, and clinical outcomes among patients with LR-MDS in South Korea. Patients and Methods: Adult patients with LR-MDS initiating treatment between 1994 and 2022 at the Samsung Medical Center were included. HCRU, medical costs, and clinical outcomes were analyzed based on RBC-TD status. Results: Among 349 patients with LR-MDS, 103 (29.5%) were RBC-TD. RBC-TD was associated with increased HCRU and medical costs compared with non-transfusion-dependent (NTD) patients. Baseline erythropoietin (EPO) levels before erythropoiesis-stimulating agent (ESA) treatment were available for 76 patients with RBC-TD. Among 51 TD patients with baseline EPO levels ≤500U/L, 20 initiated ESA treatment after RBC-TD developed, to observe only limited effectiveness. Moreover, RBC-TD patients exhibited significantly shorter overall survival, leukemia-free survival and progression-free survival compared with NTD patients. Conclusion: RBC-TD in LR-MDS imposes significant clinical and economic burdens, including poor outcomes, heightened HCRU, elevated risks of disease progression, and premature mortality. These trends were particularly pronounced in patients with LR-MDS compared with the overall MDS population, underscoring that "lower-risk" does not necessarily equate to "lower-burden".
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