Table 2.
Patient characteristics of studies.
| Study Author, Year, Country | Study Design, Setting, Sample Size | Age | Male Gender | Duration Since Diagnosis | Proportion Transfusion Dependent and Definition | IPSS Risk Groups | FAB Risk Groups | WHO Risk Groups | Mean SF at Baseline * |
| Irwin, 2011 [20] New Zealand |
Retrospective cohort Hospital 70 |
Mean (SD), years: 69.8 (NR) | 60% | NR | NR defined as the requirement of at least 1 RBC unit per 8 weeks, over at least 4 months |
Low: 41.5% Int-1: 35.0% Int-2: 15.0% High: 8.3% |
Not diagnostic but consistent with MDS: 11.4% RA: 37.0% RARS: 12.8% RAEB: 28.6% RAEB-t: 0% CMML: 10.0% |
Not diagnostic but consistent with MDS: 7.8% del(5q): 4.7% RA: 12.5% RARS: 12.5% RCMD: 25.0% RCMD-RS: 1.6% RAEB-1: 20.3% RAEB-2: 10.3% MU: 4.4% |
2963 µg/L |
| Park, 2011 [28] France |
Registry NR/unclear 318 |
Median (range), years: 77 (29–103) | 56% | NR | 0 (at registry entry) | 0: 44% 0.5: 25% 1: 11% NA by ≤1: 20% |
NR | RA: 21% RCMD: 18% RARS and RCMD-RS: 25% RAEB-1: 20% del(5q): 5% Unclassifiable: 14% |
Median (range), ng/mL: 283 (20–5558) |
| Waszczuk-Gajda, 2016 [34] Poland |
Retrospective cohort In- or outpatient hematologic unit 190 |
<50 years: 8%;50–80 years: 77%; >80 years: 15% |
58% | NR | 58 Defined as having at least 1 RBC transfusion within the last 8 weeks over a period of 4 months |
(Available for a subset of 62 patients) Low risk: 16% Int-1: 34% Int-2: 29% High risk: 21% |
NR | RA: 12.6% RARS: 3.7% RCMD: 26.3% RCMD-RS: 0.5% RAEB-1: 14.2% RAEB-2: 27.9% del(5q): 2.1% MDS-U: 4.2% |
≤1000 µg/L: 89 patients (81.7%) >1000 µg/L: 20 patients (18.3%) |
| Cakar, 2013 [15] Turkey |
Retrospective cohort Blood center records 35 |
Median (IQR), years: 60 (22–84) | 60% | NR | 62.8% needed a transfusion during follow-up | (Available for a subset of 33 patients) Low: 30.3% Int-1: 60.6% Int-2: 9.1% |
NR | RCUD: 48.6% RCMD: 2.9% RAEB-1: 28.6% RAEB-2: 17.1% Isolated del(5q): 2.9% |
At diagnosis: median (range), ng/mL: 198 (6.6–794) |
| Cermak, 2009 [16] Czech Republic |
Retrospective cohort NR/unclear 137 |
Mean (SD), years: 49.4 (17.8) | 54% | NR | NR | Low: 21.2% Int-1 and Int-2: 78.8% |
NR | RCMD, RCMD-RS: 64.2% RA, RARS, del(5q): 35.8% |
>2000 µg/L: 68 patients (49.6%) |
| Cremers, 2019 [17] European multi-country |
Prospective cohort Hospital 222 |
Median (range), years: 59.3 (19–76) | NR | Median interval between diagnosis and HSCT: 10 months (range 1–128) | NR | NR | NR | RA/RAS/del(5q)/RCMD-RS: 26% RAEB-1/RAEB-2: 56% AML-MDS: 7% CMML: 11% |
Median (1st–3rd Quartile): 700 (261–1554) ≤1000 ng/mL: 115 patients (58%) >1000 ng/mL: 81 patients (41%) |
| Diamantopoulos, 2019 [18] Greece |
Retrospective cohort NR/unclear 88 |
Median (range), years: 73.4 (35–89) | 70.6% | NR | RBC transfusion needed: 46.6% | Low: 9% Int-1: 53.8% Int-2: 37.2% High: 0% |
NR | CMML-1: 65.9% CMML-2: 34.1% |
Median (range), ng/dL: 333 (24–1541) |
| Escudero-Vilaplana, 2015 [19] Spain |
Retrospective cohort Hospital 35 |
Median age at beginning of deferasirox treatment: 68.0 years | 51.4% | NR | NR | NR | NR | NR | Median (p25–p75), µg/L: 1636 µg/L (1100–1834) |
| Kadlckova, 2017 [21] Czech Republic |
Prospective cohort Outpatient or clinic 73 |
NR | 47% | NR | 50.1% | NR | NR | RA, RCUD, RARS, RCMD, MDS-U and MDS with isolated del(5q): 68.5% RAEB-1/RAEB-2: 23.3% CMML: 8.2% |
NR |
| Kawabata, 2019 [22] Japan |
Prospective cohort NR/unclear 107 |
Median (range), years: 70 (20–94) | 67.3% | NR | NR | NR | RA: 79.4% RARS: 17.8% CMML: 2.8% |
MDS-isolated-del(5q): 1.9% MDS-SLD: 21.5% MDS-RS-SLD: 1.9% MDS-MLD: 42.1% MDS-RS-MLD: 14% MDS-F: 0.9% MDS-U: 11.2% CMML-0: 2.8% MDS/MPN-RS-T: 1.9% MDS/MPN-U: 1.9% |
Median (range), ng/mL: 204 (<7 to 14,040) |
| Kikuchi, 2012 [23] Japan |
Retrospective cohort Hospital 47 |
Low SF group, median (range), years: 67 (27–86); High SF group, median (range), years: 63 (39–74) |
Low SF group (n = 37): 51.4%; High SF group (n = 10): 90% |
NR | 0 | Low SF group (n = 37): Low: 18.9% Int-1: 56.8% Int-2: 18.9% High: 5.4%; High SF group (n = 10): Low: 0% Int-1: 40% Int-2: 50% High: 10% |
NR | Overall: RCUD: 34% RCMD: 36.2% RA + RAEB-1: 19.1% RA + RAEB-2: 10.6% |
Low SF group (n = 37): Median (range), ng/mL: 158.7 (4.0–475.6); High SF group (n = 10): Median (range), ng/mL: 793.5 (519.0–1844.0) |
| Li, 2013 [24] China |
Prospective cohort Hospital 191 |
Median (range), years: 50 (12–83) | 62% | NR | NR | Int-1: 100% | NR | RA: 9% RARS: 9% RCMD: 58% RAEB-t: 15% del(5q): 0.5% MDS-U: 8% |
Median (range), µg/L: 368 (8–3256) |
| Lucijanic, 2016 [25] Croatia |
Prospective cohort NR/unclear 36 |
Median (range), years: 74 (53–89) | 53% | NR | NR | NR | NR | RA: 36% RARS: 33% RAEB: 19% RAEB-1: 2/36 (6%) RAEB-2: 5/36 (14%) MDS-U: 8% del(5q): 1/36 (3%) |
Unclear timepoint; median (range), µg/L: HFE mutated patients: 1113; HFE wild-type patients: 458 |
| Oran, 2014 [26] USA |
Retrospective cohort Cancer center 256 |
Median (IQR), years: 56 (48–62) | NR | Median (IQR), months): 8 (5.2–15.3) | NR | IPSS-R at diagnosis: Very Low/Low: 27.8% Int: 12.5% High: 15.3% Very High: 25.7% Missing: 18.8% |
NR | RA or RARS: 15.6% RCMD: 13.7% Low/Int: 28.9% High risk: 39.1% RAEB-1: 17.6% RAEB-2: 21.5% CMML: 9% MDS-U: 23% T-MDS: 35.9% |
Median (IQR), µg/L: 1131 (521–2246) |
| Patnaik, 2010 [29] USA |
Retrospective cohort NR/unclear 88 |
Median (range): 74 (28–89) years | 68.2% | NR | Transfusion need at diagnosis: 69% | NR | NR | MDS with isolated del(5q): 100% | At diagnosis: median (range), µg/L: 330 * (8–3599) |
| Prem, 2020 [30] Canada |
Retrospective cohort Cancer center 125 |
≤65 years: 69.6% >65 years: 30.4% |
66.1% | NR | 44.8% | IPSS score: Low: 5.7% Int-1: 16.9% Int-2: 56.5% High: 21% Missing: n = 2 IPSS-R score: Very Low/Low: 12.2% Intermediate: 20.3% High: 33.3% Very High: 34.2% Missing: n = 2 |
NR | MDS subtype: RA/RCMD/Hypoplastic MDS: 36% RAEB-1: 20.8% RAEB-2: 43.2% |
>1000 ng/mL: 52.5% of patients ≤1000 ng/mL: 47.5% of patients |
| Risum, 2016 [31] Denmark |
Prospective cohort hematologic center at hospital 60 |
Median (range), years: 75.5 (46–94) | 63.3% | Median (range), months: 16.5 (0.5–186.5) | 35% | At diagnosis: (n) IPSS: (out of 56) Low: 24 Int-1: 24 Int-2: 5 High: 3 IPSS-R: (out of 56) Very Low: 12 Low: 29 Int: 7 High: 4 Very High: 4 At time of TE: (n) IPSS: (out of 57) Low: 29 Int-1: 16 Int-2: 5 High: 7 IPSS-R: (out of 57) Very Low: 21 Low: 18 Int: 6 High: 5 Very High: 7 |
NR | At time of TE: (n) RA: 2 RARS: 16 RCMD: 19 RAEB-1: 4 RAEB-2: 4 MDS del(5q): 5 AML (progressed from MDS): 3 CMML: 6 MDS/MPN: 1 |
Unclear timepoint: Transfusion dependent (n = 21), median (range), µg/L: 1035 (249–30,195); Transfusion independent (n = 39), median (range), µg/L: 390 (6–1866) |
| Senturk-Yikilmaz, 2019 [32] Turkey |
Retrospective cohort Hospital 62 |
Mean (SD), years: 67.7 (12.3) | 67.7% | NR | NR | NR | NR | MDS subtype: SF ≥ 400 ng/mL: RA: 9.7% RARS: 1.6% RCMD: 14.5% RCMD-RS: 1.6% RAEB-1/-2: 19.4% SF < 400 ng/mL: RA: 22.6% RARS: 1.6% RCMD: 19.4% RCMD-RS: 3.2% RAEB-1/-2: 6.5% |
Median (range), ng/mL: 358.5 (29.8–2000) |
| Sperr, 2010 [33] Austria |
Retrospective cohort Outpatient or clinic hematologic center 419 |
Median (IQR), years: 71 (24–91) | 54.4% | NR | NR | Low: 135 (32.2%) Int-1: 158 (37.7%) Int-2: 79 (18.9%) High: 47 (11.2%) |
RA: 128 (30.5%) RARS: 94 (23.4%) RAEB: 109 (26.0%) RAEB-t: 63 (15.0%) CMML: 25 (6.0%) |
NR | NR |
| Wong, 2018 [35] Canada |
Retrospective cohort Hospital 182 |
ICT patients, median (range), years: 67 (32–87); Non-ICT patients, median (range), years: 74 (39–93) |
ICT: 60.3% Non-ICT: 57.1% |
NR | NR | ICT: Low: 47.6% Int-1: 42.9% ≤Int-1: 9.5% Non-ICT: Low: 38.7% Int-1: 58.0% ≤Int-1: 3.4% |
FAB or WHO, depending on era ICT: RA: 20.6% RARS, RARS-t: 44.4% RCMD, RCMD-RS: 23.8% del(5q): 4.8% RAEB-1: 3.2% MDS-U/MDS/MPN-U: 3.2% Non-ICT: RA: 20.2% RARS, RARS-t: 26.1% RCMD, RCMD-RS: 31.1% del(5q): 5.0% RAEB-1: 10.1% MDS-U/MDS/ MPN-U: 9.4% |
FAB or WHO, depending on era ICT: RA: 20.6% RARS, RARS-t: 44.4% RCMD, RCMD-RS: 23.8% del(5q): 4.8% RAEB-1: 3.2% MDS-U/MDS/MPN-U: 3.2% Non-ICT: RA: 20.2% RARS, RARS-t: 26.1% RCMD, RCMD-RS: 31.1% del(5q): 5.0% RAEB-1: 10.1% MDS-U/MDS/MPN-U: 9.4% |
Median (range), ng/mL: ICT: 687 (49–6447); Non-ICT: 260 (31–7783) |
| Osanai, 2018 [27] Japan |
Retrospective cohort NR/unclear 98 |
Median (range), years: 71 (20–91) | 60.2% | NR | NR | NR | NR | NR | NR |
* Except when indicated otherwise. Abbreviations: CMML, chronic myelomonocytic leukemia; del(5q), deletion of part of long arm of human chromosome 5; FAB, French–American–British; HSCT, hematopoietic stem cell transplant; ICT, iron chelation therapy; Int, Intermediate; IPSS, International Prognostic Scoring System; IPSS-R, Revised International Prognostic Scoring System; IQR, interquartile range; MDS, myelodysplastic syndromes; MDS-F, MDS with fibrosis; MDS-MLD, MDS with multilineage dysplasia; MDS-RS-MLD, MDS with ring sideroblasts and multilineage dysplasia; MDS-RS-SLD, MDS with ring sideroblasts and single lineage dysplasia; MDS-SLD, MDS with single lineage dysplasia; MDS-U, myelodysplastic syndromes, unclassifiable; MPN, myeloproliferative neoplasm; MPN-RS-T, MPN with ring sideroblasts and thrombocytosis; MPN-U, MPN, unclassifiable; MU, myelodysplasia unspecified; NA, not applicable; NR, not reported; RA, refractory anemia; RAEB, refractory anemia with excess blasts; RAEB-t, refractory anemia with excess blasts in transformation; RARS, refractory anemia with ring sideroblasts; RARS-t, refractory anemia with ring sideroblasts with thrombocytosis; RBC, red blood cell; RCMD, refractory cytopenia with multilineage dysplasia; RCMD-RS, refractory cytopenia with multilineage dysplasia and ring sideroblasts; RCUD, refractory cytopenia with unilineage dysplasia; SD, standard deviation; SF, serum ferritin; TE, transient elastography; T-MDS, treatment-related myelodysplastic syndromes; WHO, World Health Organization.