How Does Myelodysplastic Syndrome Affect Patients' Quality of Life?

Study Methodology

For newly diagnosed patients with MDS, classification criteria are available to help clinicians plan therapy. However, in practice, differences in patients' quality of life have been observed depending on their age, gender, or risk of disease progression.

A recently published study analyzed data from 927 adults newly diagnosed with MDS. The Quality of Life Questionnaire – Core30 (QLQ-C30) was used to assess the quality of life. It consists of 5 functional scales (physical, social, emotional, cognitive, and ability to perform daily activities) and 1 scale assessing overall health/quality of life. Additionally, the questionnaire evaluates the frequency of common cancer symptoms (fatigue, pain, nausea/vomiting, shortness of breath, loss of appetite, insomnia, diarrhea, constipation, and financial difficulties). The value range for each parameter is 0–100, with 100 corresponding to the highest quality of life.

The prognosis of patients was determined using the IPSS (International Prognostic Scoring System) score, taking into account the revised version IPSS-R. IPSS divides patients into 4 groups based on the risk of disease progression (low, intermediate-1, intermediate-2, and high risk).

Results

The median age of the evaluated patients was 71.6 years. 54.4% had at least one comorbidity. 70.3% lived with a partner, and the majority had a medium (42.8%) or lower (43.5%) level of education. In the sample, 54.6% (according to IPSS) / 42.2% (according to IPSS-R) were low-risk patients and 45.4% (according to IPSS) / 57.8% (according to IPSS-R) were high-risk patients.

Among men with lower risk of progression, significant differences in quality of life were observed between younger (30–59 years) and older individuals. At least one group of older patients had clinically significantly worse results in 11 quality of life scales compared to the youngest age group, with better values only in the financial domain. For women, at least one older age group had clinically significantly worse results in 6 out of 10 quality of life scales compared to the youngest age group.

Conversely, in high-risk progression MDS patients, the youngest group showed a trend towards the overall worst quality of life results. In men, at least one older age group had clinically significantly better quality of life results than the youngest age group in 9 out of 12 scales, and in women in 6 out of 8 scales. Generally, men had higher quality of life scores than women.

Men with low risk of progression most frequently described worsening physical condition (54%), shortness of breath (53%), and fatigue (29%), while women reported physical condition (65%), shortness of breath (55%), and emotional state (42%). High-risk progression patients most frequently described worsening physical condition (men 61%, women 77%), shortness of breath (men 60%, women 62%), and fatigue (men 41%, women 52%).

Discussion and Conclusion

Surprisingly, high-risk progression MDS patients from the youngest group (30–59 years) exhibited worse functional status and higher frequency of accompanying symptoms (mainly fatigue and shortness of breath) than at least one older age group. Conversely, this trend was not observed in low-risk progression MDS patients. This finding partly aligns with results from previous studies in patients with solid tumors, where younger groups with metastases reported higher intensity of accompanying symptoms than older groups, and the reverse was true for earlier stages of the disease.

The study found clinically significant issues in more than half of the patients already at the diagnosis of MDS. Generally, women exhibited higher intensity of issues compared to men in several functional aspects. The results can help clinicians better understand the impact of MDS on patients' quality of life.

(dape)