APLASTIC ANEMIA | Incidence and Clinical Management in Spain Consistent with Other Studies

 An observational study at 7 hospitals in Spain demonstrated the incidence of aplastic anemia and clinical management for patients in Spain was consistent with other international and national studies.

The study was carried out through a multicenter, ambispective, observational approach encompassing 7 Spanish hospitals, catering to roughly 3.91 million individuals, over the span from 2010 to 2019. The research team examined the rate of occurrence, clinical handling, reaction to therapy, and patient survival rates.

“Despite being a rare condition and the recent therapeutic advances, aplastic anemia is still a significant burden for affected patients and healthcare systems alike, particularly due to the high morbidity of this disease,” the authors wrote in their report. “We aimed to obtain information regarding the incidence and epidemiology of [aplastic anemia] in a well-defined population in Spain, covering distinct geographic regions.”

Out of the population, 106 patients were confirmed with aplastic anemia, which corresponds to an incidence rate of approximately 2.83 cases per million people per year. The median onset age was noted as 61 years old (within a spectrum of 12-86 years), with a relatively even distribution between males (46.3%) and females (57.3%). Upon first evaluation, aplastic anemia severity was categorized as moderate in around 35.8% of patients, severe in 25.3%, and very severe in 30.5%. It was observed that a majority of patients—93.7%—needed blood transfusions.

The overall response rate to first-line therapy was 53.2% at 3 months, 68.3% at 6 months, and 86% at 1 year. The 5-year overall survival (OS) was 73.6%. The 5-year OS was lower in patients with moderate (68.4%) disease than those with severe (78.6%) and very severe (74.6%) disease. The 5-year OS was 100% in patients 0-25 years of age and 58.3% in patients ≥60 years of age. At last contact (July 31, 2019), 75.8% of the patients were alive.

The study identified a rate of [aplastic anemia] at 2.83 occurrences for every million people each year, which is consistent with the findings of the International Agranulocytosis and Aplastic Anemia Study. This rate aligns with the findings of other studies within European and Latin American populations, as reported by the researchers. They noted that while the prognosis for aplastic anemia has seen significant improvements over the last ten years, older patients aged 60 and above still have a lower overall survival (OS) rate compared to their younger counterparts.

The research faced several limitations, including incomplete data for certain patients; the challenge of conducting comparative analysis of treatment outcomes due to the limited number of participants for some treatments; and the fact that not all Spanish hospitals treating aplastic anemia participated in the research.

Source: Haematology Advisor

Vallejo C, Rosell A, Xicoy B, et al. A multicentre ambispective observational study into the incidence and clinical management of aplastic anaemia in Spain (IMAS study)Ann Hematol. Published online January 4, 2024.

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