Challenges of measuring overall survival in elderly patients with MDS

During the MDS Hub Steering Committee meeting held on November 14, 2022, Theo de Witte chaired a discussion on the challenges of measuring overall survival in elderly patients with myelodysplastic syndromes (MDS), with contributions from Rena Buckstein, Moshe Mittelman, Mikkael Sekeres, and Alex Smith.

de Witte outlines the differences in overall and relative survival according to iron toxicity, transfusion dose density, and Revised International Prognostic Scoring System risk group. Moving forward, De Witte goes on to describe the causes of death in patients with lower-risk MDS, including the substantial proportion of patients that die from competing causes, and the committee debates the difficulties in determining whether cause of death is related to MDS. They also discuss the use of relative survival as a parameter when identifying competing reasons for the cause of death in elderly patients with MDS, and how this outcome could be used alongside other clinical data to better elucidate the impact of MDS on mortality.