Morphology control of volatile resistive switching in La0.67Sr0.33MnO3 thin films on LaAlO3 (001)

Introduction: Treatment for myelodysplastic syndromes (MDS) is complex, options are limited, and insight into
consecutive treatments is lacking. We performed this study to assess the outcomes in a real-world cohort of
patients with MDS.
Materials and Methods: An observational population-based study was performed using the HemoBase registry.
Treatment patterns and overall survival (OS) were analyzed with Kaplan-Meier analyses.
Results: In 144 of 280 (51.4%) patients with MDS >50 years, first-line treatment was initiated. The median age
was 75.1 years (range: 52.6–92.0); the majority were male (72.2%). Hypomethylating agents (HMA), intensive
chemotherapy, lenalidomide, and erythropoiesis-stimulating agents (ESA) were given as first-line treatment to
31.1% (n = 45), 12.5% (n = 18), 2.8% (n = 4), and 53.5% (n = 77) of the population, respectively. The median
treatment duration was 5.8 months (95% Confidence Interval [CI]: 1.1–10.4) for HMA, 1.7 months (95%CI:
0.9–2.6) for intensive chemotherapy, 10.8 months (95%CI: 4.7–17.0) for lenalidomide, and 14.8 months (95%CI:
11.4–18.1) for ESA. Consecutive treatments were given to 27.2% of patients. The main reasons for first-line
treatment discontinuation were treatment failure (45.8%), toxicity (6.9%), or death (20.1%). Median OS after
termination of the initial, second, and third treatment was 5.8 months (95%CI: 3.2–8.5), 9.3 months (95%CI:
0.0–19.6), and 1.0 months (95%CI: 0.0–5.1), respectively.
Discussion: This study shows the treatment outcomes in a real-world population of older patients with MDS.
Treatment duration and median OS after treatment discontinuation were relatively limited. There is still an
urgent need for new treatment options, strategies to further optimize duration of existing treatments, and
communication of realistic treatment goals and expectations, especially for older, higher-risk patients with MDS
with a poor prognosis.