Patterns of care and patients' outcomes for myelodysplastic syndromes in Puerto Rico: A real-world data analysis

Abstract Background: Myelodysplastic syndromes (MDS) are a group of rare blood cancers with a wide range of clinical outcomes and a highly variable prognosis. Usually, most population-based registries do not collect cancer-related biological and genetic markers, which limits the use of population-based registries to address critical research questions. We leveraged the Puerto Rico (PR) Central Cancer Registry (PRCCR) to collect this data and analyze clinical characteristics and outcomes of patients diagnosed with MDS in PR. Methods: The study population includes patients diagnosed with MDS in PR between 2015 and 2019. Descriptive statistics and frequency analysis were used to describe the variables of interest. Logistic regression models were used to examine factors associated with the use of genetic marker tests. Bivariate analyses were performed to evaluate association between treatment patterns and patients’ characteristics. Three-year survival curves were estimated using Kaplan-Meier (with log-rank test to assess differences between survival curves). Multivariable Cox regression models were used to estimate the magnitude of association between the risk of dying among patients with MDS and different genetic markers/clinical characteristics. Results: The study cohort consisted of 475 patients. Between 67.2% and 81.7% of cases reported information of laboratory tests and prognostic markers. The abnormal karyotype had the highest presence in patients with MDS among those that reported the test with 47.4%. After adjusting for variables of interest, the risk of dying in MDS patients who did not have a del(5q) or a mutation of TP53, EZH2, or NRAS was 53%-85% lower than the risk of dying in patients who had either one of the mutations (p<0.05). Almost half of the MDS patients (47.4%) received treatment and of those, almost a third (29.3%) received it within the first 30 days after the diagnosis of MDS. The most common first-course treatment was azacitidine (52.0%), followed by lenalidomide (20.0%). Patients with a very low IPSS-R had a 3-year survival of 72.8% and those with a very high IPSS-R had a 3-year survival of 7.8%. Conclusion: The data from the PRCCR confirm the prognostic value of the IPSS-R and the role of the cytogenetic and molecular abnormalities on the patient’s outcomes. Citation Format: Karen J. Ortiz-Ortiz, Tonatiuh Suárez Ramos, Maira A. Castañeda-Avila, Carlos R. Torres-Cintrón, Axel Gierbolini-Bermúdez, Guillermo Tortolero-Luna. Patterns of care and patients’ outcomes for myelodysplastic syndromes in Puerto Rico: A real-world data analysis [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C032.