1. Investigational intervention: Blood transfusion support
  2. For what level of MDS severity risk: All
  3. What subtype of MDS: All
  4. Aims and benefits: This is a randomised, single-blind, controlled trial comparing quality of life in patients with MDS transfused to two different haemoglobin levels.
    • Group A - Restrictive transfusion strategy
    • Group B - Liberal transfusion strategy
  5. Basic inclusion criteria:
    • All patients with MDS ≥ 18 years of age and with < 20% blasts on bone marrow aspirate (including non-proliferative CMML and other MDS/MPN overlap diseases)
    • Transfusion dependent: at least 1 red cell transfusion episode per month in the last 8 weeks
    • Life expectancy >6 months
  6. Basic exclusion criteria:
    • Unable, in the opinion of the attending clinician, to tolerate restrictive or liberal red cell transfusion thresholds
    • ECOG performance status ≥ 3
    • Patients being actively treated with erythropiesis stimulating agents (ESAs) or disease modifying agents for their MDS (such as lenalidomide, azacitidine, hydroxycarbamide, experimental agents)
    • Patients with myelofibrosis
    • Patients in whom the attending clinician considers that active bleeding or on-going haemolysis contribute significantly to the cause of anaemia
    • Patients presenting with splenomegaly >5cm below the costal margin
  7. Trial sites/locations and name of physician in charge of trial: Royal Bournemouth Hospital; Aberdeen Royal Infirmary; Great Western Hospital; Nottingham University Hospitals NHS Trust; St James Hospital, Leeds; Churchill Hospital, Oxford; Birmingham Heartlands Hospital; Freeman Hospital, Newcastle; Salisbury Hospital
  8. More information:

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