(PB2779) Chart review study on dose modifications of patients with myelodysplastic syndrome treated with hypomethylating agents

A retrospective chart review study was conducted using electronic medical records (EMR) data from the ConcertAI Oncology Dataset. The study included 250 MDS patients who initiated HMA therapy following diagnosis: 100 patients received oral DEC-C, 100 received parenteral AZA, and 50 received parenteral DEC. Patients were selected through stratified random sampling based on the first HMA in the structured EMR data. Patient characteristics were examined using the structured data. Treatment modification was assessed based on physician documentation in the unstructured EMR data for patients with confirmed MDS diagnosis and HMA therapy.

Among the 250 cases reviewed, 222 patients had confirmed MDS diagnosis and 192 received HMA therapy, including 57 treated with oral DEC-C, 98 with parenteral AZA, and 37 with parenteral DEC, as confirmed through chart review. The year of initial MDS diagnosis of the 192 patients ranged from 2005 to 2024, with 91 (47.3%) patients diagnosed on or after 2020. The median age was 71 years, with 38% of patients being female, 73% White, and 90% receiving care in a community setting. Approximately 13% of the 192 patients had an ECOG performance status of 2 or higher, and 23% had a Charlson Comorbidity Index (CCI) score of 2 or higher. Among the 57 patients who received oral DEC-C as their first HMA, 79% experienced dose modifications, with 65% undergoing delayed start of subsequent treatment cycle, 39% having decreased dosing durations, and 56% discontinuing treatment. Of the 98 patients treated with parenteral AZA as their first HMA, 95% had dose modifications, including 65% with delayed start of subsequent treatment cycle, 24% with decreased dosing durations, 9% with dose reductions, and 90% discontinuing treatment. Among the 37 patients who received parenteral DEC as their first HMA, 75% experienced dose modifications, with 51% having delayed start of subsequent treatment cycle, 16% having decreased dosing durations, 8% undergoing dose reductions, and 54% discontinuing treatment (Figure 1).