PB1349 - Clinical relevance and management of bleeding in patients with myelodysplastic syndromes and severe thrombotytopenia: a retrospective analysis

Tuesday, June 27, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

RT

Riccardo Tomasello

Resident in Hematology
University of Palermo
Palermo, Sicilia, Italy

Co-Author(s)

MM

Marta Mattana

PhD student
University of Palermo
Palermo, Sicilia, Italy
CC

Claudia Cammarata

Resident in hematology
University of Palermo
Palermo, Sicilia, Italy
AL

Alessandro Lucchesi

MPN and rare hematologic disease program leader
IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori"
Meldola, Emilia-Romagna, Italy
gg

giulio giordano

Physician
A. Cardarelli Hospital, Campobasso
Campobasso, Sicilia, Italy
SS

Sergio Siragusa

Professor of Hematology
Haematology Unit, Thrombosis and Haemostasis Reference Regional Center, University of Palermo, Palermo, Italy
Palermo, Sicilia, Italy

Presenting Author(s)

Mariasanta Napolitano, 310885

Associate Professor of hematology
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
Palerno, Sicilia, Italy

Background: Myelodysplastic syndromes (MDS) are hematological malignancies characterized by unilineage or mulitineage cytopenia(s), often treated with hypomethtylating agents (HMA). Persistently low platelet (PLT) counts can result in increased bleeding risk, moreover, HMA may induce or worsen thrombocytopenia, increasing the need for platelet transfusions (PLT-T) and the risk of refractoriness to PLT-T over time.

Aims: This retrospective, observational study on patients affected by MDS reports data on the clinical significance of persistent severe thrombocytopenia, in terms of hemorrhagic complications, morbidity, and mortality related to bleeding.

Methods: The study included 60 consecutive patients (M:F ratio 1.7:1, median age 76.5y - range: 55-92), diagnosed with MDS and severe thrombocytopenia (PLT < 50000/μL) between 2012 and 2022, managed at our Hematology Department. The patient sample did not include 5q- MDS. The following data were collected and analyzed: median PLT count at diagnosis, median PLT nadir, treatment with HMA, the occurrence of bleeding events, management of bleeding, use of thrombopoietin receptor agonists (TPO-RAs), transfusion need, hospitalization, MDS staging according to International Prognostic Staging System. Informed consent was signed by each participant, the study was approved by the local IRB.

Results: MDS characteristics of the enrolled cohort are listed in Table.1. Characteristics of bleeding and specific management are described in Figure.1. All the enrolled patients had a negative bleeding history before the diagnosis of MDS. Our results show a relatively low morbidity and mortality directly correlated with thrombocytopenia in MDS.

Conclusion(s): Severe thrombocytopenia in MDS is a challenging scenario due to the lack of effective specific therapeutic options. Our retrospective analysis shows that different therapeutic options, with either symptom controlling or curative intent, including TPO_RA in low risk MDS,are taken in clinical practice to face bleeding in these patients solid evidences on a common and shared approach are still lacking.