Blood cancers

Infection rate in MDS under the microscope

Infection is a relatively common and important problem in myelodysplastic syndrome (MDS) and an independent risk factor for mortality, the HAA 2017 Annual Scientific Meeting was told.

One of the largest ever data sets, comprising more than 3,000 MDS patients admitted to public and private hospitals in Victoria from 1998 to 2010, found more than 60% of patients were either admitted with an infection or developed an infection while in hospital.

Common pathogens included gram-negative bacteria, candida, staphylococcus and viruses such as herpes. Vaccine preventable infections were uncommon.

Researcher Dr Allison Mo, from Monash Health and Monash University, told the limbic the mortality rate was about 82% in patients with infection compared to 60% in patients without an infection.

She said guidelines regarding prophylaxis were targeted at very high-risk patients such as those facing intensive chemotherapy or transplants rather than MDS patients in general.

“If we can identify other patients at higher risk earlier and target with prophylaxis, that could be helpful,” Dr Mo said.

The study found patient comorbidities such as cardiac failure, lung disease and

diabetes with complications were associated with an increased risk of infection.

However more work in the form of prospective studies was required to determine the efficacy of prophylaxis to prevent infections.

Dr Mo said the data predates the availability of azacitidine, which may be associated with a different risk of infection.

The older age and associated comorbidities of MDS patients meant they were not often eligible for clinical trials and there was a paucity of good data.

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