Grip strength is associated with overall survival in myelodysplastic syndrome

Frailty is increasingly recognized as important to outcomes in Myelodysplastic Syndrome (MDS). Physical performance measures such as grip strength are common markers associated with frailty and predict mortality in other cancer populations. The value of these markers in MDS accounting for patient and disease specific factors is not well described. The MDS-CAN registry (NCT02537990) of patients with MDS, MDS/MPN, or low-blast AML (20-30%) was used to evaluate the association between physical performance measures and survival. Specific physical performance assessments included grip strength, 4-meter walk test, and 10× sit-stand test. Among 1,372 patients in our cohort (mean age 73.5 years), median follow-up was 2.8 years and 60.6% died. Median OS increased across grip strength quartiles, from 23.6 months in the lowest quartile to 45.0 months in the highest, while five-year OS was 39.3% in patients with grip strength above the median versus 27.5% below. Faster 4-meter walk, and shorter sit-stand times were also associated with improved OS but in multivariable analysis, only grip strength retained significance. Grip strength below the median remained independently associated with worse OS, alongside Rockwood Clinical Frailty Scale, IPSS-R, age over 70, ferritin, fatigue, and comorbidity burden. Grip strength is a simple tool associated with survival in MDS, providing prognostic information beyond established frailty and disease-based risk scores. The incorporation of physical performance measures may enhance risk stratification and inform future studies on treatment outcomes.

Authors

Institutions

Publication Details

Journal
Blood Advances
Published
2026-09-24
DOI
https://doi.org/10.1182/bloodadvances.2026021036
Primary Topic
Acute Myeloid Leukemia Research
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
article

Grip strength is associated with overall survival in myelodysplastic syndrome

Akhil Rajendra, James T. England, Brian F. Leber, Brett L. Houston et al.
Blood Advances
Acute Myeloid Leukemia Research
article

Grip strength is associated with overall survival in myelodysplastic syndrome

Akhil Rajendra, James T. England, Brian F. Leber, Brett L. Houston, Ivan Landego, Thomas J. Nevill, Robert Delage, Heather A. Leitch, Eve St. Hilaire, Rena J. Buckstein, Alejandro Garcia‐Horton, Karen W L Yee, Jill Fulcher, Grace Christou, Mitchell Sabloff, Laura Anne Habib, Lee Mozessohn, Amy M. Trottier, Signy Chow, Lisa Chodirker, Michelle N. Geddes, Liying Zhang, April Shamy, Nancy Yan Zhu, Nicholas Finn, Mohamed Elemary, John Storring, Mohammed Siddiqui, Matthew C Cheung, Nicholas L.J. Chornenki, James A Kennedy
article en

Abstract

Frailty is increasingly recognized as important to outcomes in Myelodysplastic Syndrome (MDS). Physical performance measures such as grip strength are common markers associated with frailty and predict mortality in other cancer populations. The value of these markers in MDS accounting for patient and disease specific factors is not well described. The MDS-CAN registry (NCT02537990) of patients with MDS, MDS/MPN, or low-blast AML (20-30%) was used to evaluate the association between physical performance measures and survival. Specific physical performance assessments included grip strength, 4-meter walk test, and 10× sit-stand test. Among 1,372 patients in our cohort (mean age 73.5 years), median follow-up was 2.8 years and 60.6% died. Median OS increased across grip strength quartiles, from 23.6 months in the lowest quartile to 45.0 months in the highest, while five-year OS was 39.3% in patients with grip strength above the median versus 27.5% below. Faster 4-meter walk, and shorter sit-stand times were also associated with improved OS but in multivariable analysis, only grip strength retained significance. Grip strength below the median remained independently associated with worse OS, alongside Rockwood Clinical Frailty Scale, IPSS-R, age over 70, ferritin, fatigue, and comorbidity burden. Grip strength is a simple tool associated with survival in MDS, providing prognostic information beyond established frailty and disease-based risk scores. The incorporation of physical performance measures may enhance risk stratification and inform future studies on treatment outcomes.

Blood Advances
Dalhousie University (CA), Sunnybrook Health Science Centre (CA), University of British Columbia (CA), University of Ottawa (CA), University of Alberta (CA), University of Toronto (CA), Ottawa Hospital (CA), Jewish General Hospital (CA), Health Sciences Centre (CA), Princess Margaret Cancer Centre (CA), Vancouver General Hospital (CA), Royal Victoria Hospital (CA), Saskatchewan Cancer Agency (CA), Hôpital de l'Enfant-Jésus (CA), St. Paul's Hospital (CA), Dr. Georges-L.-Dumont University Hospital Centre (CA), Saskatoon Cancer Centre (CA), Odette Cancer Centre (CA), University of Manitoba (CA), McGill University (CA), McMaster University (CA)
Good health and well-being
Openalex Percentile: Top 11%
Acute Myeloid Leukemia Research
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.