What does this research mean for the field?

In patients with myelodysplastic syndromes, severe bone marrow fibrosis (MF-2/3) is an independent adverse prognostic factor for long-term survival and severe infectious complications during hypomethylating agent therapy, despite comparable short-term response rates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the impact of bone marrow fibrosis on treatment response, overall survival, and adverse events in patients with myelodysplastic syndromes with excess blasts undergoing hypomethylating agent monotherapy.

September 3, 2026European journal of medical researchOpen Access

Efficacy and prognosis of hypomethylating agent therapy in patients with myelodysplastic syndromes with bone marrow fibrosis

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Authors

YZYoushan Zhao JGJuan Guo 洪洪明华

Discussion

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Overview

Retrospective analysis reveals poorer survival and higher toxicity with hypomethylating agents in myelodysplastic syndromes with fibrosis, indicating that severe fibrosis impairs long-term outcomes.

Key Points

To evaluate the impact of bone marrow fibrosis on treatment response, overall survival, and adverse events in patients with myelodysplastic syndromes with excess blasts undergoing hypomethylating agent monotherapy.
Analyzed 200 patients with myelodysplastic syndromes with excess blasts (118 with MDS-EB-1 and 82 with MDS-EB-2; median age 65 years) receiving hypomethylating agent monotherapy between March 2010 and March 2023 at Shanghai Sixth People's Hospital.
Assessed response rates, response duration, and safety profiles across fibrosis grades (MF-2/3 vs. MF-0/1) using Kaplan–Meier survival analysis and Cox proportional hazards regression models.
Overall response rates (50.9% vs. 53.7%, P = 0.873) and complete remission rates (26.4% vs. 25.2%, P = 1.000) did not differ significantly between MF-2/3 and MF-0/1 cohorts.
Patients with MF-2/3 exhibited significantly shorter median overall survival (14 vs. 18 months, P = 0.020; multivariate HR = 1.449, 95% CI 1.022–2.055, P = 0.037) and median duration of response (5 vs. 9 months, P = 0.036).
Severe adverse events were more frequent in the MF-2/3 cohort, including grade 4 neutropenia (88.7% vs. 74.8%, P = 0.035), grade 4 infections (66.0% vs. 44.9%, P = 0.008), and treatment-related mortality (26.4% vs. 7.5%, P = 0.001).

Cite This Study

Zhao et al. (2026) studied this question.

synapsesocial.com/papers/6a9934ea636c6408cfa7cb9e https://doi.org/10.1186/s40001-026-05127-9

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September 3, 2026European journal of medical researchOpen Access

Efficacy and prognosis of hypomethylating agent therapy in patients with myelodysplastic syndromes with bone marrow fibrosis

View Full Paper

Ask AI

Bookmark

Authors

YZYoushan Zhao JGJuan Guo 洪洪明华

Discussion

Member takes

Overview

Retrospective analysis reveals poorer survival and higher toxicity with hypomethylating agents in myelodysplastic syndromes with fibrosis, indicating that severe fibrosis impairs long-term outcomes.

Key Points

To evaluate the impact of bone marrow fibrosis on treatment response, overall survival, and adverse events in patients with myelodysplastic syndromes with excess blasts undergoing hypomethylating agent monotherapy.
Analyzed 200 patients with myelodysplastic syndromes with excess blasts (118 with MDS-EB-1 and 82 with MDS-EB-2; median age 65 years) receiving hypomethylating agent monotherapy between March 2010 and March 2023 at Shanghai Sixth People's Hospital.
Assessed response rates, response duration, and safety profiles across fibrosis grades (MF-2/3 vs. MF-0/1) using Kaplan–Meier survival analysis and Cox proportional hazards regression models.
Overall response rates (50.9% vs. 53.7%, P = 0.873) and complete remission rates (26.4% vs. 25.2%, P = 1.000) did not differ significantly between MF-2/3 and MF-0/1 cohorts.
Patients with MF-2/3 exhibited significantly shorter median overall survival (14 vs. 18 months, P = 0.020; multivariate HR = 1.449, 95% CI 1.022–2.055, P = 0.037) and median duration of response (5 vs. 9 months, P = 0.036).
Severe adverse events were more frequent in the MF-2/3 cohort, including grade 4 neutropenia (88.7% vs. 74.8%, P = 0.035), grade 4 infections (66.0% vs. 44.9%, P = 0.008), and treatment-related mortality (26.4% vs. 7.5%, P = 0.001).

Cite This Study

Zhao et al. (2026) studied this question.

synapsesocial.com/papers/6a9934ea636c6408cfa7cb9e https://doi.org/10.1186/s40001-026-05127-9

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