Patient-reported fatigue refines prognosis in higher-risk myelodysplastic syndromes (MDS): a MDS-CAN study

Br J Haematol. 2021 Jul;194(2):319-324. doi: 10.1111/bjh.17537. Epub 2021 May 31.

Abstract

The incorporation of patient-reported outcomes with traditional disease risk classification was found to strengthen survival prediction in patients with myelodysplastic syndromes (MDS). In the present Canadian MDS registry analysis, we validate a recently reported prognostic model, the Fatigue-International Prognostic Scoring System among higher-risk patients [FA-IPSS(h)], which incorporates patients' reported fatigue, assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life-Core 30 (QLQ-C30), with a threshold of ≥45 points, in higher IPSS score, stratifying them into distinct subgroups with different survival outcomes. We further validated this concept, using the Revised IPSS >3·5 as cut-off for the definition of higher-risk MDS, and patients' reported fatigue according to Edmonton Symptom Self-Assessment Scale (ESAS) Global Fatigue Scale (GFS), a single-item fatigue rating scale, which is easier to deploy. This emphasises the power of self-reported fatigue at refining overall survival predictions in higher-risk MDS and further bolsters the importance of considering patient-related outcomes in global assessments.

Keywords: fatigue; high-risk; myelodysplastic syndromes; patient-reported outcomes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Canada / epidemiology
  • Fatigue / complications*
  • Fatigue / diagnosis
  • Fatigue / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / complications*
  • Myelodysplastic Syndromes / diagnosis
  • Myelodysplastic Syndromes / epidemiology
  • Patient Reported Outcome Measures
  • Prognosis
  • Quality of Life
  • Registries