Do anemia treatments improve quality of life and physical function in patients with myelodysplastic syndromes (MDS)? A systematic review

Transfusion Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia; Department of Haematology, Monash Health, Clayton, Australia; Austin Pathology & Department of Haematology, Heidelberg, Australia. Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. Transfusion Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia; Department of Haematology, Monash Health, Clayton, Australia. Department of Haematology, Monash Health, Clayton, Australia; School of Clinical Sciences, Monash University, Australia. Systematic Review Initiative, NHS Blood and Transplant, Oxford, United Kingdom. Transfusion Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia. Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, Australia. Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; NHS Blood and Transplant, John Radcliffe Hospital, Oxford, United Kingdom; Radcliffe Department of Medicine, University of Oxford, United Kingdom. Transfusion Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia; Department of Haematology, Monash Health, Clayton, Australia. Electronic address: zoe.mcquilten@monash.edu.

Blood reviews. 2023;:101114
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PICO Summary

Population

Patients with myelodysplastic syndromes (26 studies, n= 2,211).

Intervention

Systematic review assessing whether improvements in anaemia are associated with changes in health-related quality of life (HRQoL)/physical function.

Comparison

Outcome

Interventions included: growth factors/erythropoiesis-stimulating agents, red cell transfusion, erythroid maturation agents, or a combination. Five randomised controlled trials reported no changes in HRQoL despite erythroid response to the intervention, raising the question of whether anaemia treatment alone can effectively improve HRQoL. Many studies were considered at high risk of bias for assessing HRQoL.
Abstract
Anemia is common in Myelodysplastic Syndromes (MDS). Different anemia treatments have been tested in clinical studies, but the full impact on patients' health-related quality of life (HRQoL) and physical function is unknown. The main aim of this review was to assess whether improvements in anemia are associated with changes in HRQoL/physical function. Twenty-six full-text publications were identified, enrolling 2211 patients: nine randomized trials (RCTs), fourteen non-randomized studies of interventions and three cross-sectional studies. Interventions included: growth factors/erythropoiesis-stimulating agents (n = 14), red cell transfusion (n = 9), erythroid maturation agents (n = 1), or a combination (n = 2). Five RCTs reported no changes in HRQoL despite erythroid response to the intervention, raising the question of whether anemia treatment alone can effectively improve HRQoL. Many studies were considered at high risk of bias for assessing HRQoL. There is a pressing need for future clinical trials to better define the nature of the relationship between anemia and HRQoL/functional outcomes.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine