Few With Myelodysplastic Syndromes Receive Hypomethylating Agents
MONDAY, Aug. 11, 2025 -- Few patients with myelodysplastic syndromes (MDS) receive treatment with hypomethylating agents (HMAs), with evidence of age-, sex-, and race-related disparities, according to a study published online Aug. 5 in Blood Neoplasia.
Sudipto Mukherjee, M.D., Ph.D., M.P.H., from the Taussig Cancer Institute at the Cleveland Clinic, and colleagues examined factors associated with patterns of HMA use in patients with MDS in a retrospective cohort study involving 49,514 individuals aged 65 years and older with incident MDS during 2012 to 2013.
The researchers found that 16.1 percent of patients received HMAs. Compared with younger individuals (65 to 74 years), the oldest age cohort (85 years and older) had lower odds of receiving HMAs (adjusted odds ratio, 0.41). Significantly lower odds of receiving HMAs were seen for women and Black patients versus men and White patients (adjusted odds ratios, 0.81 and 0.70, respectively). Factors associated with lower odds of receiving four or more cycles of HMAs included treatment with decitabine, having two to three cytopenias, being nursing home residents, and having high frailty (adjusted odds ratios, 0.70, 0.69, 0.64, and 0.50, respectively).
"Given the absence of newly approved therapies over the last two decades, the most impactful way to improve outcomes in newly diagnosed high-risk MDS requires that we do better with the available therapies," Mukherjee said in a statement. "Making changes with these therapies and how they are given (that is, when to treat and how to treat) is a key intervention that can have a huge impact."
Several authors disclosed ties to the biopharmaceutical industry.
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