Session: 903. Health Services and Quality Improvement –Myeloid Malignancies: Poster III
Hematology Disease Topics & Pathways:
Clinical Practice (Health Services and Quality), Clinical Research, Diseases, Myeloid Malignancies
Methods: This is a retrospective chart review including patients treated in the community oncology network and identified in the Integra PrecisionQ deidentified database. Patients were identified as diagnosed with HR-MDS between January 1, 2014 and June 30, 2022, using a combination of ICD codes and receipt of hypomethylating agents in line with National Comprehensive Cancer Network guidelines as their first treatment. Eligible patients had at least 3 months of follow-up and at least 6 months of look-back prior to HR-MDS diagnosis. Signs and symptoms such as fatigue, weight loss, bruise, chills, night sweats, anemia, thrombocytopenia, and neutropenia that initiated the HR-MDS diagnosis journey were collected by manual curation.
Results: A total of 350 patients aged 18 years or older diagnosed with HR-MDS over the study period were selected. The majority of patients included in this sample were White (82.6%) and male (59.4%) (Table 1). More than 50% of the 350 patients were ≥75 years old at diagnosis and most of them (91%) were diagnosed by a hematologist/oncologist in an outpatient setting. The median time from first sign/symptom to bone marrow biopsy and treatment initiation were 19.3 months (interquartile range [IQR] 8.9, 44.3) and 22 months (IQR 11.4, 45.8), respectively. Of the 350 patients included in the study, 342 (97.7%) had at least 1 sign or symptom leading to HR-MDS diagnosis, with the majority of patients presenting with anemia (77.2%), followed by thrombocytopenia (66.4%), fatigue (64.3%), and neutropenia (43.3%). International Prognostic Scoring System (IPSS) scores were not documented for nearly half (43.7%) of the patients included in this chart review.
Conclusions: This initial analysis highlights several challenges in the HR-MDS patient care journey, including long time intervals elapsed between first sign/symptom and bone marrow biopsy, leading to further treatment, accompanied by a relatively high absence of IPSS score documentation. These findings suggest several potential opportunities to optimize patient care, such as shortening the time from symptoms to diagnosis and time from diagnosis to treatment, utilization and documentation of IPSS score, and prompt treatment initiation. Ultimately, this program aims to utilize this Phase 1 data to identify the gaps in care and to formulate quality measures to optimize care and facilitate timely diagnosis and appropriate treatment initiation among HR-MDS patients.
Disclosures: Rossetti: MPN Support Group: Speakers Bureau; Imago BioSciences, Inc., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA: Research Funding; Leukemia and Lymphoma Society: Membership on an entity's Board of Directors or advisory committees; Integra Connect: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Medical Writing, Speakers Bureau; CTI BioPharma Corp: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Medical Writing, Speakers Bureau; Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Choksi: Integra Connect: Consultancy, Other: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events and support for attending meetings and/or travel . Vasudevan: IntegraConnect, Precision Q: Current Employment. Blanc: IntegraConnect, Precision Q: Current Employment. Brenneman: IntegraConnect, Precision Q: Current Employment. Wang: IntegraConnect, Precision Q: Current Employment. McMahon: Gilead Sciences, Inc.: Current Employment. Beal: Gilead Sciences, Inc.: Current Employment, Other: Restricted Stock. Jhaveri: Gilead Sciences, Inc.: Current Employment, Other: Stock or other ownership. Williamson: Gilead Sciences, Inc.: Current Employment, Current equity holder in publicly-traded company; F. Hoffmann-La Roche AG: Current equity holder in publicly-traded company; Amgen Inc.: Current equity holder in publicly-traded company. Hogea: Gilead Sciences, Inc.: Current Employment.
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