What question did this study set out to answer?

The study aims to evaluate the clinical and economic impacts of red blood cell transfusion-dependence in patients with lower-risk myelodysplastic syndromes.

April 18, 2026Journal of Blood Medicine0 citationsOpen Access

Impact of Transfusion Dependence on Clinical and Economic Burden in Patients with Lower-Risk Myelodysplastic Syndromes: A 28-Year Retrospective Study

JJJun Ho Jang CJChul Won Jung DCDae-Ho Choi

Puntos clave

The study aims to evaluate the clinical and economic impacts of red blood cell transfusion-dependence in patients with lower-risk myelodysplastic syndromes.
Conducted a 28-year retrospective study at Samsung Medical Center.
Included adult patients with lower-risk myelodysplastic syndromes initiating treatment from 1994 to 2022.
Analyzed healthcare resource utilization, medical costs, and clinical outcomes based on transfusion-dependence status.
29.5% of 349 patients were found to be red blood cell transfusion-dependent.
Transfusion-dependence was linked to increased healthcare resource utilization and medical costs.
Transfusion-dependent patients had significantly shorter overall and progression-free survival compared to non-transfusion-dependent patients.

Resumen

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”. Keywords: hematopoietic stem-cell malignancies, healthcare resource utilization, red blood cell transfusion, real-world

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