Surviving MDS: Why Blood Counts Matter! | Ira Zackon, MD

Hi, I'm Dr. Ira Zaycon. I am a Senior Medical Director with ONTADA, where we conduct research, cancer research, using records of patients so that we can learn from patients, and that's important. And I've also been a practicing hematologist for almost 30 years. So I want to share with you some of our research that we're presenting here at the annual American Side of Hematology meeting. So this study we did looked at people with what's called the myelodysplastic syndromes, or MDS. Our bone marrow makes our blood, and these are chronic bone marrow diseases where we start to underproduce the blood cells that circulate. So we have white blood cells, we have red blood cells, we have cells called platelets, and anemia, which is a low red blood cell count, is probably the most common abnormality that we see, and patients can experience fatigue and limiting symptoms. And so some of the therapy is directed at trying to improve that anemia. What we were testing was that in some other settings of other anemias, maintaining people at a not normal, but a closer to normal red blood cell level, we based that on what's called hemoglobin, it's just the protein that's a big part of the red cells that carries oxygen, that if you maintain a mild anemia, including if you have to give blood transfusions, that some patients will do much better. This is an inherited anemia, but based on that, meaning they live longer, and there was less heart problems or heart causes of death. So we wanted to look at our MDS population, who tend to be elderly or older, and just hypothesize, you know, might it be true in MDS in terms of maintaining? So what we did was we identified a large number, it was over 6,500 patients, and we looked at patients who presented with this mild dysplastic syndrome, an anemia of significance, and we divided it into three groups, those that were able to achieve a mild anemia, we could say by hemoglobin over 10, and then a moderate anemia, a hemoglobin between 8 and 10. Normal for most women is 12-ish, and for men it's more like 14, so to give it a sense, and then more severe anemia, less than 8. And we looked at these patients and their overall survival, which means, okay, how long did they live with this diagnosis? When we looked at the group that were able to achieve a mild anemia, they clearly lived significantly longer. In our study, it was close to five years. If you had a more severe anemia, that was all you could achieve over time. You know, that was about a year of survival, and then the other group was kind of in between. So it just was raising the question of the importance of maintaining a mild anemia and achieving it. There's different ways that that can be done. There's medicines that we have to try and help the bone marrow make those red blood cells better. Sometimes you have to transfuse patients. And this study is a very, what we call, high level. It was just kind of testing the question. There's a lot more detail that would need to be studied, and that would be the next phase of the research to really get at important details that we need to understand to say, well, is this really true? And then if it's true, understanding why. And therefore, that might change the way we think about, you know, how we are goals of therapy, okay? Because for example, we don't transfuse red blood cells routinely. We allow our patients to live with moderate or sometimes more severe anemia because the tendency is not to over transfuse. But we don't know, you know, if that might be an issue in terms of how things play it over years. So I don't want to overstate this. This is a very, I would say, preliminary kind of inquiry of some data. And it needs another phase of more comprehensive analysis. And maybe we'll talk next year about where we're at with that. If our videos have helped you in any way, and you're able to, please consider making a donation to help us continue this important work. Your gift will go three times as far when we reach $500,000 by the end of the year. Every contribution, big or small, makes a difference. And we're deeply grateful for your support.