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

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.

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Copyright © 2023. Published by Elsevier Ltd.

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Declaration of Competing Interest AM is supported by scholarship funding from National Health and Medical Research Council (NHMRC), Haematology Society of Australia and New Zealand (HSANZ), National Blood Authority (NBA) and Monash University. This work is also supported by the NHMRC funded Blood Syneergy program. MP is supported by the National Institute for Health Research (NIHR). ZM and JS are supported by Australian NHMRC Emerging Leadership Fellowships. EW is supported by NHMRC Leadership Fellowship. ZM and EW have also received support for other research work (not related to this submitted work) from Abbvie, Amgen, Antegene, AstraZeneca, Beigene, Bristol Myers-Squibb/Celgene, CSL Behring, Dova/Sobi Pharmaceuticals, Janssen, Novartis, Roche, Sanofi, Takeda. JS has received research funding (not related to this submitted work) from Amgen, Bristol Myers Squibb, Astex; and is on advisory boards for Novartis, Mundipharma, Otsuka, Astellas, Bristol Myers Squibb, Pfizer and on the speakers bureau for Mundipharma and Novartis. SS, JSa, CD, SB, EL, NS have no disclosures.