Myelodysplastic syndromes (MDSs) treatment focuses on improving quality of life (QOL), affected by anemia and transfusion dependence (TD). Using the MDS-CAN registry, we studied how changes in transfusion status - TD to transfusion independence (TI) (group A), or vice versa (group B), and maintaining TD (group C) or TI (group D) - affected OS and QOL in 1120 MDS patients. Analysis showed superior OS for those remaining TI, poorer for those remaining TD, and intermediate for those with changes. Among 656 treated patients, group A (n = 54) showed improved QOL, with trends toward improved physical and social function scores. Group B (n = 151) experienced declines in global QOL measures after switching to TD, particularly in fatigue and physical, role, and social functioning. Group C had notable fatigue worsening, while group D showed milder declines across multiple QOL aspects. Achieving TI in MDS correlates with improved QOL, whereas reverting to TD more significantly worsens overall QOL and function scores.
Keywords: Myelodysplastic syndromes; hypomethylating agent; quality of life; transfusion status.