Survival disparities with racial, age, and sex differences in myelodysplastic syndromes: A Surveillance, Epidemiology, and End Results analysis (2014-2020).

Abstract

e18576 Background: Myelodysplastic syndromes (MDS) are a diverse group of clonal hematologic disorders characterized by ineffective hematopoiesis and variable clinical outcomes. This study explores disparities in five-year relative survival rates among MDS patients by race/ethnicity, sex, and age, utilizing the SEER (Surveillance, Epidemiology, and End Results) database (2014–2020). Methods: This retrospective Cohort study was conducted on patients with MDS. Data from SEER registries (excluding Illinois and Massachusetts) were analyzed. The study cohort comprised 30,827 MDS patients. Survival estimates were calculated using SEER’s life table approach, stratifying data by sex, age (<50, 50–64, ≥65), and race/ethnicity (Non-Hispanic White, Non-Hispanic Black, Hispanic, Non-Hispanic Asian/Pacific Islander, Non-Hispanic American Indian/Alaska Native). Results: Females exhibited higher five-year survival compared to males across all age groups (41.6% vs. 34.8%), with the largest gap observed in the <50 age group (60.4% vs. 49.8%). Among racial/ethnic groups, Non-Hispanic Black individuals had the highest five-year survival (42.6%), followed by Hispanics (38.1%), Non-Hispanic Whites (37.1%), and Non-Hispanic Asians/Pacific Islanders (36.5%). Non-Hispanic American Indian/Alaska Natives showed survival rates of 39.8%, though wide confidence intervals were noted due to limited sample size. Age showed the strongest survival disparity. Younger patients (<50 years) had significantly better survival compared to older age groups. Hispanics and Non-Hispanic Asians/Pacific Islanders aged <50 demonstrated survival rates of 59.6% and 64.3%, respectively. Survival dropped sharply among older patients (≥65 years), with Non-Hispanic Asians/Pacific Islanders (27.3%) and males showing the lowest survival. Conclusions: This analysis identifies notable survival disparities in MDS, with significant differences by sex, age, and race/ethnicity. Female sex, younger age, and Non-Hispanic Black race were associated with favorable outcomes. Older patients, particularly males and Non-Hispanic Asians/Pacific Islanders, exhibited the poorest survival rates. Addressing these disparities requires targeted research into genetic, environmental, and healthcare access factors.