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The anemia-independent impact of myelodysplastic syndromes on health-related quality of life

Lookup NU author(s): Dr Ge YuORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s). Myelodysplastic syndromes (MDS) are in the majority of cases characterized by anemia. Both anemia and MDS per se may directly contribute to impairments in health-related quality of life (HRQoL). In this study, we aimed to investigate the anemia-independent impact of MDS on HRQoL. We evaluated participants (≥ 50 years) from the large population-based Lifelines cohort (N = 44,694, mean age 59.0 ± 7.4 years, 43.6% male) and the European MDS Registry (EUMDS) (N = 1538, mean age 73.4 ± 9.0 years, 63.0% male), which comprises a cohort of lower-risk MDS patients. To enable comparison concerning HRQoL, SF-36 scores measured in Lifelines were converted to EQ-5D-3L index (range 0–1) and dimension scores. Lower-risk MDS patients had significantly lower HRQoL than those from the Lifelines cohort, as illustrated in both the index score and in the five different dimensions. Multivariable linear regression analysis demonstrated that MDS had an adjusted total impact on the EQ-5D index score (B = − 0.12, p < 0.001) and an anemia-independent “direct” impact (B = − 0.10, p < 0.001). Multivariable logistic regression analysis revealed an anemia-independent impact of MDS in the dimension mobility, self-care, usual activities, and anxiety/depression (all except pain/discomfort). This study demonstrates that the major part of the negative impact of lower-risk MDS on HRQoL is not mediated via anemia. Thus, the therapeutic focus should include treatment strategies directed at underlying pathogenic mechanisms to improve HRQoL, rather than aiming predominantly at increasing hemoglobin levels.

Publication metadata

Author(s): Wouters HJCM, Conrads-Frank A, Koinig KA, Smith A, Yu G, de Witte T, Wolffenbuttel BHR, Huls G, Siebert U, Stauder R, van der Klauw MM

Publication type: Article

Publication status: Published

Journal: Annals of Hematology

Year: 2021

Volume: 100

Pages: 2921-2932

Print publication date: 01/12/2023

Online publication date: 02/09/2021

Acceptance date: 24/08/2021

Date deposited: 22/09/2021

ISSN (print): 0939-5555

ISSN (electronic): 1432-0584

Publisher: Springer Nature


DOI: 10.1007/s00277-021-04654-1


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