Assessment of Epoetin Alfa in Patients with Myelodysplastic Syndrome Utilizing an Electronic Medical Record Database.

BACKGROUND: There are limited data from electronic medical record studies that provide a real-world view of practice patterns of epoetin alfa (EPO) as supportive therapy in patients with myelodysplastic syndrome (MDS). This retrospective, observational study was conducted to gain a better understanding of the demographics, real-world treatment patterns, and clinical outcomes for patients with MDS receiving EPO.

METHODS: Electronic medical record data from a large oncology/hematology practice in the southeastern United States were collected from January 1, 2005 to September 30, 2006. Inclusion criteria consisted of patients receiving ≥ 2 doses of EPO with a diagnosis of MDS within 30 days prior to or during EPO treatment episode. All other cancer diagnoses were excluded. Baseline characteristics, EPO dosing, change in Hb levels, and response to EPO (attainment of Hb ≥ 11.0 g/dL at any point during the treatment episode from a baseline Hb < 11g.dL) were measured. EPO treatment episode was defined as continuous treatment with EPO and without EPO administration 35 days prior to or after the last administration. Weekly (QW) dosing was defined as ≤ 9 days, every 2 week dosing (Q2W) was defined as 9.1–18.0 days, and every 3 weeks (Q3W) was defined as > 18.1 days.

RESULTS: A total of 166 patients were included in the analysis; 63.9% women, mean age was 76.2 ± 11.3 years. The mean starting dose was 44,518 ± 11,258 units (median = 40,000 units), and the mean administered dose (any dose of EPO) was 45,587 ± 10,351 units (median=40,000 units). The mean cumulative dose (sum of all EPO doses during the treatment episode) was 312,349 ± 453,551 units. Weekly dosing was administered in 38.0% of patients while 34.9% of patients received Q2W dosing and 27.1% received Q3W dosing. Mean Hb at baseline was 10.6 ± 1.1 mg/dL and increased to 11.3 ± 1.7 mg/dL after 12 weeks of EPO therapy. Fifty percent of the patients responded to treatment and the mean time to response was 33.2 days.

DISCUSSION: This study provides insight into real-world treatment patterns and clinical outcomes for patients with MDS treated with EPO. Additional real-world studies may be warranted to validate these findings.