P. De Fabritiis

P-170 Clinical complications in outpatient myelodysplastic syndromes

The aim of our research is to evaluate the rate, the type, the severity, the causative factors, and the pathogenesis of complications during the course of myelodysplastic syndromes (MDS). Complications among MDS patients on outpatient management were prospectively recorded and classified. During an 18-month observation period, complications emerging in 48 outpatients with MDS, of whom 15 (31%) were on active treatment and 33 (69%) were receiving best supportive care alone, were recorded and analyzed. Out of 48 patients (median age, 72 years), 34 (71%) experienced complications; a total number of 92 events were recorded; most frequently observed events were infections (43 events, 47%) and bleeding (11 events, 12%). Complications are a frequent issue in MDS; preventive measures should be directed toward the most frequently observed complications.

346 Home care management of transfusions in patients with myelodysplastic syndromes

Background: The majority of patients diagnosed with myelodysplastic syndromes (MDS) are individuals of older age often afflicted by several comorbid conditions for which they are generally unsuitable for disease-modifying treatments. Introduction. The treatment of anemia is an essential part of the global management of most MDS patients. In erythropoietin-failed patients or in those unsuitable for this option, red blood cell (RBC) transfusions remain the only available measure. For this category of frail patients and for their families, home care (HC) represents a valuable option allowing to preserve the patient’s quality of life and to avoid useless hospital admissions. Purpose. Evaluating the safety, the feasibility and reliability of a two-year home care program focusing on RBC transfusion management during. Material and Methods: There were 62 MDS (23 male) with a median age of 86 (69–98) years. Patients were followed at home for a mean of 8.7 (1–24) months. Therapy with erythropoietin stimulating agents was used in 40 (65%) patients. Results: Overall, 49 patients required transfusions, for a total of 628 RBC units; RBC units/transfused pt were a median of (1–62) 9. Older age, a lower baseline Hb concentration, the time for the primary diagnosis of MDS and of transformation into an acute myeloid leukemia strongly correlated with the number of transfused RBC units. All transfusions were safely administered at home without any untoward effect. Conclusion: QoL is a particularly important issue for older MDS patients. With this regard, management of chronic patients requiring multiple and repeated admissions to receive RBC transfusions may be a concern for the affected individual and for its family. Our experience demonstrated that the administration of RBC transfusion at home is a feasible, reliable and effective in our older MDS patient, avoiding social and economic costs due to an inappropriate removal from his domestic environment. In conclusion, in our experience domiciliary management of RBC transfusions represented an important added value to home care program, allowing the best humanization of this procedure for our patients with MDS.