Abstract
BACKGROUND: The hypomethylating agent azacitidine (AZA) is the most widely used first-line treatment for patients with higher-risk myelodysplastic syndromes (MDS) due to its survival benefits. Effective management of higher-risk MDS requires addressing not only clinical outcomes but also the burden of healthcare resource utilisation (hospitalisations and transfusions), which remains poorly characterised. METHODS: We conducted a retrospective, population-based study of patients diagnosed with higher-risk MDS treated with AZA between 2010 and 2022. We collected clinical data, including transfusions and hospitalisations, by detailed review of medical records from the initiation of AZA and up to 12 cycles. RESULTS: In total, 103 patients were included, and 94% required supportive care during treatment. Healthcare resource utilisation peaked during the first four cycles. Hospitalisation was necessary for 75% of the patients, and 28% were hospitalised ≥ 3 times. Red blood cell (RBC) transfusions were required for 78% of the patients in the first cycle, and 30% achieved RBC transfusion independence. CONCLUSION: This study highlights the substantial healthcare resource utilisation for patients with higher-risk MDS receiving AZA, which emphasises the importance of considering these factors in treatment planning. TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.