Myelodysplasic Syndromes and Risk Factors for Infection

Study Overview
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Brief Summary
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Myelodysplastic Syndromes (MDS) are characterized by quantitative and qualitative bone marrow failure and by a disorder of the medullary production which is a pre-leukemic state which can evolve into acute myeloid leukemia. The risk of leukemic transformation is estimated by the score IPSS (International Prognostic Score System). We distinguish the MDS of low risk (IPSS<1) and those of high risk of leukemic transformation (IPSS=1,5). Besides the risk of leukemic transformation, MDS much be complicated of infections which could be life-threatening. The risk of developing first infection after the diagnosis of MDS of high risk is probably influenced by anamnestic (disease duration, comorbidities), clinical (veinous central catheter, previous hospitalization), biological (neutropenia, lymphopenia, serum ferritin) and therapeutics (demethylating agent, lenalidomide, erythropoietin, G-CSF, transfusions, anti-infectious preventive treatment) factors. Their identification will allow for improved targeting of the population which is is likely to benefit from anti-infective prophylaxis Primary objective is to identify risk factors associated with first acute episode of infection in patients with MDS, by comparing index cases and matched control cases who did not develop infection episode since diagnosis. Secondary objectives are to explore nature and severity of infectious episodes, number of recurrences during 1 year of follow up and survival at 6 and 12 months

Detailed Description
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160 couples (Case / Control) Pairing according to age (+/- 5 years), sex and medical consultation date (+/-15 days) Follow up at M3, M6, M9 and M12 Study duration : 24 months Inclusion duration : 12 months

Official Title
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Myelodysplasic Syndromes and Risk Factors for Infection : A Case / Control Study

Conditions
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IPSS High Risk, Myelodysplastic Syndrome (MDS), Infection, Risk Factors

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 18 years old MDS with IPSS >1.5 With a first infectious episode since the diagnosis of SMD of high risk (Case) Unhurt of any infection and being able to be mated in the case index (Control) Consulting or hospitalized in one of the services involved in the study during the period of inclusion Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Case group<br>Patient developing a first episode of infection since diagnosis of high-risk MDS (index case) | Other: No intervention<br> <br> |
| Control group<br>Patient with no infection since diagnosis of MDS Patient will be paired to index case by: Hospital site Age Sexe Control patient is eligible if he has been seen in consultation within 15days before or after date of first infection of index case If matching fails, control patient can be found in another site and/or within 30days before or after date of first infection of index case | Other: No intervention<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Occurrence of infectious episode |  | 12 months follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| severity of infectious episode |  | 12 months follow-up | 
| Overall Survival (all-cause mortality) |  | 12months follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Infection, Myelodysplastic syndrome (myelodysplasia), Risk Factors