The role of comorbidity indices in the prognosis of elderly MDS patients

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Published: 21 Feb 2011
Views: 7450
Prof Valeria Santini - University of Florence, Italy
Prof Valeria Santini talks about the results of her research on the use of comorbidity indexes to determine prognosis for elderly myelodysplastic syndrome patients treated with azacitidine. This trial found that elderly patients with comorbidities can be treated successfully with azacitidine without any substantial increase in adverse effects, however, the level of comorbidities did have a negative influence on overall survival. Prof Santini goes on to discuss the key topics that will be covered at the haematological ecancer conference, Rome 18-20th March 2011.

2010 American Society of Hematology Annual Meeting 3rd - 7th December

Interview with Valeria Santini - University of Florence, Italy

The role of comorbidity indices in the prognosis of elderly MDS patients


Speaker key


IV         Interviewer

VS        Valerie Santini




IV         Could you tell us just a little bit about your study will you, please?


VS        Yes.  We started to evaluate our patients with MDS, who are mainly elderly people above 60 years of age, and above 75 in the majority of cases, for their co-morbidities because we had the impression, and now we have the data, showing that patients with high scores of co-morbidity do not get appropriate treatment.


IV         Now, you're using azacytidine?


VS        Exactly.


IV         What difference did the co-morbidities make?


VS        Now, in fact patients with high co-morbidity evaluated with different scores receiving azacytidine, did show the same improvement, haematological improvement, complete remission, as patients without co-morbidities.  Meaning that in fact we have to treat these patients, and they deserve to be treated with the standard azacytidine therapy as the other ones, even if co-morbidities, of course influence outcome in the sense of overall survival because of their intrinsic severity.


IV         Within that group of older patients were there differences between sub groups of patients?


VS        Indeed.  In patients with lower co-morbidities – you know that co-morbidities are judged by scores, precise scores – they do get shorter overall survival even if they respond well to azacytidine.  So now our further goal and steps will be addressed to evaluate whether treatment with azacytidine significantly prolonged survival even in co-morbid patients.


IV         So what is the main message coming out of your study?


VS        The main message is that patients, or elderly patients, and especially very elderly, so above 75 years of age, should be evaluated also with co-morbidity scores before treating with azacytidine, but they have to be treated.


IV         But they do benefit?


VS        They do benefit, they do achieve a response, and they do not show more adverse events or less tolerance than not co-morbid ones.


IV         And I can’t possibly let you go without asking you about the Rome meeting because there is a meeting in Rome, in 2011, in March that we’re all getting quite excited about, and it’s about cancer in older patients.  What do you think is the importance of this meeting?  You’re on the steering committee, aren’t you?


VS        Yes.  The meeting; I look forward to this meeting because we are going to discuss thoroughly the problems relating to ageism in a way, so the fact that many elderly persons do not receive appropriate treatment. We want to discuss the data showing exactly the countries so that the patients, despite their age can really take... have a significant advantage by being treated appropriately.


IV         So you’re saying there can be discrimination?


VS        Absolutely, yes.


IV         But you think this could change?


VS        It must change because patients are really responding, they have longer survival for solid tumours and haematological diseases – so there is a lot of attention now directly to elderly cancer patients.


IV         Valeria Santini, thank you very much for joining me here...


VS        You’re welcome.


IV         ... on a busy day at the American Society of Hematology.


VS        Extremely busy.


IV         I hope to catch up with you in Rome at the cancer meeting, so thanks for being on ecancerTV.


VS        Thanks.