PCN44 Systematic Literature Review of Clinical Outcomes, Economic Burden, and Humanistic Burden of Anemia in Patients with Myelodysplastic Syndromes

Anemia in patients with myelodysplastic syndromes (MDS) is associated with adverse clinical outcomes. This study aimed to summarize the relationship between anemia and the clinical, humanistic, and economic outcomes in MDS patients. A separate systematic literature review (SLR) was conducted for each of the 3 outcomes. Searches in EMBASE, MEDLINE, and EconLit were performed in February 2019. Studies were excluded if key outcomes of interest in adult MDS patients were not reported. The results were summarized qualitatively. Four cohort studies provided evidence on clinical outcomes, 2 of which suggested anemia significantly worsens mortality. Marisavljevic 2014 suggested that hemoglobin (Hb) concentration was an independent risk factor for survival (p=0.008). Garcia-Manero 2008 found that overall survival (OS) was worse in anemic patients (20.3 and 26.6 months, Hb<10 and Hb=10.0–11.9 g/dL, respectively) compared with non-anemic patients (48.5 months, Hb>12 g/dL; p<0.0001). Mirza 2001 indicated that OS was numerically higher in the anemic group (30.2 months, Hb<10 g/dL versus 23.4 months, Hb>10 g/dL; p=0.27). Marisavljevic 2004 reported a numerically lower proportion of anemic (23%) versus non-anemic (28%) patients alive after 5 years. The humanistic SLR identified 9 studies. Among MDS patients, anemia was associated with decreased quality of life (QoL), measured by the functional well-being domain of QoL-E (Oliva 2005: p=0.07), overall QUALMS (Abel 2016: 64.8 versus 71.1; p<0.01), and EORTC QLQ-C30 fatigue scale (Luskin 2017: mean difference=16.3; p<0.001). Similarly, 4 studies found a significant correlation between higher Hb and improved QoL. The SLR found no studies reporting evidence on the relationship between anemia and economic burden in MDS patients. The majority of evidence highlights the increased mortality and decreased QoL associated with anemia in MDS patients. Limitations include inconsistencies and gaps in the literature especially regarding the economic burden of anemia in MDS patients.