Influence of different therapy strategies in patients with myelodysplastic neoplasms (MDS) on overall survival with regard to different decades: data from the German MDS registry

Over the history of myelodysplastic neoplasms (MDS), an increasing number of treatment modalities have become available. It is therefore important to assess whether these developments have translated into improved overall survival (OS) for patients. We analyzed data from 1,147 patients in the German MDS registry and observed a progressive improvement in median survival across three diagnostic periods: until 2000 (20 months), 2001-2010 (31 months), and after 2011 (57 months). Patients treated with allogeneic stem cell transplantation (SCT) had the best prognosis with a median survival of 108 months. Over time, both the proportion of patients undergoing allogeneic SCT (6.3% vs. 22.1% vs. 40.0%) and the median age at transplantation (36.5 vs. 52 vs. 61 years) increased. Notably, OS also improved among patients treated with best supportive care (BSC) alone (17 vs. 31 vs. 64 months; p < 0.001). Multivariate analysis demonstrated that the period of first diagnosis had an independent positive effect on survival. The underlying reasons for this improvement remain unclear, but a multifactorial origin-including improved supportive measures and greater eligibility for allogeneic SCT-must be considered.