{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:17:50Z","timestamp":1784305070726,"version":"3.55.0"},"reference-count":32,"publisher":"American Society of Hematology","issue":"5","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Population-based studies that contain detailed clinical data on patients with myelodysplastic syndrome (MDS) are scarce. This study focused on the real-world overall survival (OS) of MDS patients in association with comorbidities, specifically malignancies. An observational population-based study using the HemoBase registry was performed, including all patients with MDS diagnosed between 2005 and 2017 in Friesland, a Dutch province. Detailed information about diagnosis, patient characteristics, previous treatment of malignancies, and comorbidities according to the Charlson Comorbidity Index (CCI) was collected from electronic health records. Patients were followed up until June 2019. Kaplan-Meier plots and Cox regression analyses were used to study survival differences. In the 291 patients diagnosed with MDS, the median OS was 25.3 months (95% confidence interval [CI], 20.3-30.2). OS was significantly better for patients with CCI score &amp;lt;4, age &amp;lt;65 years, female sex, and low-risk MDS. Fifty-seven patients (20%) had encountered a prior malignancy (excluding nonmelanoma skin cancer), and a majority (38 patients; 67%) were therapy related. Both therapy-related and secondary MDSs were associated with worse OS (hazard ratio, 1.51; 95% CI, 1.02-2.23 and 1.58; 95% CI, 0.95-2.65, respectively), as compared with de novo MDS patients (P = .04). Patients in remission at time of MDS diagnosis had a similar median OS compared with patients with de novo MDS (25.5 vs 28.3 months). This population-based study involving all newly diagnosed MDS patients over a 13-year period in Friesland showed that multiple comorbidities, including previous malignancies, are associated with shorter OS. OS was not related to the use of radiotherapy or chemotherapy.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020003381","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T16:55:32Z","timestamp":1614790532000},"page":"1344-1351","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":16,"title":["Comorbidities and malignancies negatively affect survival in myelodysplastic syndromes: a population-based study"],"prefix":"10.1182","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9454-8637","authenticated-orcid":false,"given":"Johanne","family":"Rozema","sequence":"first","affiliation":[{"name":"Unit of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands;"},{"name":"Department of Clinical Pharmacy and Pharmacology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mels","family":"Hoogendoorn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robby","family":"Kibbelaar","sequence":"additional","affiliation":[{"name":"Pathology Friesland, Leeuwarden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8629-7535","authenticated-orcid":false,"given":"Eva","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nic","family":"Veeger","sequence":"additional","affiliation":[{"name":"Science Bureau, Medical Center Leeuwarden, Leeuwarden, The Netherlands; and"},{"name":"Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"van Roon","sequence":"additional","affiliation":[{"name":"Unit of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands;"},{"name":"Department of Clinical Pharmacy and Pharmacology and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"issue":"20","key":"2021030420235136900_B1","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"issue":"19","key":"2021030420235136900_B2","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1056\/NEJMra0902908","article-title":"Myelodysplastic syndromes","volume":"361","author":"Tefferi","year":"2009","journal-title":"N Engl J Med"},{"issue":"7","key":"2021030420235136900_B3","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.amjmed.2012.04.014","article-title":"Epidemiology of myelodysplastic syndromes","volume":"125","author":"Ma","year":"2012","journal-title":"Am J Med"},{"issue":"18","key":"2021030420235136900_B4","doi-asserted-by":"crossref","first-page":"2738","DOI":"10.1182\/bloodadvances.2019000293","article-title":"Representation of therapy-related myelodysplastic syndrome in clinical trials over the past 20 years","volume":"3","author":"Borate","year":"2019","journal-title":"Blood Adv"},{"issue":"5","key":"2021030420235136900_B5","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1182\/blood-2009-03-209262","article-title":"The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes","volume":"114","author":"Vardiman","year":"2009","journal-title":"Blood"},{"issue":"10","key":"2021030420235136900_B6","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s10552-007-9060-2","article-title":"A population-based study of survival in patients with secondary myelodysplastic syndromes (MDS): impact of type and treatment of primary cancers","volume":"18","author":"De Roos","year":"2007","journal-title":"Cancer Causes Control"},{"issue":"1","key":"2021030420235136900_B7","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/ejh.13243","article-title":"Factors predicting early mortality after new diagnosis of myelodysplastic syndrome: a population-based study","volume":"103","author":"Jacobsen","year":"2019","journal-title":"Eur J Haematol"},{"issue":"5","key":"2021030420235136900_B8","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/j.ejca.2013.12.002","article-title":"Trends in incidence, initial treatment and survival of myelodysplastic syndromes: a population-based study of 5144 patients diagnosed in the Netherlands from 2001 to 2010","volume":"50","author":"Dinmohamed","year":"2014","journal-title":"Eur J Cancer"},{"issue":"5","key":"2021030420235136900_B9","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/bjh.15243","article-title":"Prognostic scoring systems for myelodysplastic syndromes (MDS) in a population-based setting: a report from the Swedish MDS register","volume":"181","author":"Moreno Berggren","year":"2018","journal-title":"Br J Haematol"},{"issue":"8","key":"2021030420235136900_B10","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1111\/trf.12054","article-title":"Myelodysplastic syndrome incidence, transfusion dependence, health care use, and complications: an Australian population-based study 1998 to 2008","volume":"53","author":"McQuilten","year":"2013","journal-title":"Transfusion"},{"issue":"8","key":"2021030420235136900_B11","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1080\/10428194.2016.1267350","article-title":"The incorporation of comorbidities in the prognostication of patients with lower-risk myelodysplastic syndrome","volume":"58","author":"Falantes","year":"2017","journal-title":"Leuk Lymphoma"},{"issue":"8","key":"2021030420235136900_B12","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/j.leukres.2015.05.007","article-title":"Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes","volume":"39","author":"Balleari","year":"2015","journal-title":"Leuk Res"},{"issue":"3","key":"2021030420235136900_B13","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s12032-018-1094-7","article-title":". 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