Predictive Model for Infection Risk in Myelodysplastic Syndromes, Acute Myeloid Leukemia, and Chronic Myelomonocytic Leukemia Patients Treated With Azacitidine; Azacitidine Infection Risk Model: The Polish Adult Leukemia Group Study.

Adult Aged Aged, 80 and over Anti-Bacterial Agents / therapeutic use Antibiotic Prophylaxis / methods Antifungal Agents / therapeutic use Antimetabolites, Antineoplastic / adverse effects Azacitidine / adverse effects Bacterial Infections / chemically induced Female Health Status Indicators Humans Kaplan-Meier Estimate Leukemia, Myeloid, Acute / drug therapy Leukemia, Myelomonocytic, Chronic / drug therapy Male Middle Aged Mycoses / chemically induced Myelodysplastic Syndromes / drug therapy Poland / epidemiology Proportional Hazards Models Retrospective Studies Risk Assessment / methods Treatment Outcome

Acute leukemia Azacitidine Chronic myelomonocytic leukemia Infections Myelodysplastic syndromes

Journal

Clinical lymphoma, myeloma & leukemia

ISSN: 2152-2669

Titre abrégé: Clin Lymphoma Myeloma Leuk

Pays: United States

ID NLM: 101525386

Informations de publication

Date de publication:
05 2019

Historique:

received: 22 10 2018

revised: 04 01 2019

accepted: 10 01 2019

pubmed: 23 3 2019

medline: 7 7 2020

entrez: 23 3 2019

Statut: ppublish

Résumé

Myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML), and acute myeloid leukemia (AML) patients, including those treated with azacitidine, are at increased risk for serious infections. The aim of our study was to identify patients with higher infectious risk at the beginning of azacitidine treatment. We performed a retrospective evaluation of 298 MDS/CMML/AML patients and included in the analysis 232 patients who completed the first 3 cycles of azacitidine therapy or developed Grade III/IV infection before completing the third cycle. Overall, 143 patients (62%) experienced serious infection, and in 94 patients (41%) infection occurred within the first 3 cycles. The following variables were found to have the most significant effect on the infectious risk in multivariate analysis: red blood cell transfusion dependency (odds ratio [OR], 2.38; 97.5% confidence interval [CI], 1.21-4.79), neutropenia <0.8 × 10 We selected a subset with high early risk for serious infection and worse clinical outcome among patients treated with azacitidine.

Sections du résumé

BACKGROUND

PATIENTS AND METHODS

We performed a retrospective evaluation of 298 MDS/CMML/AML patients and included in the analysis 232 patients who completed the first 3 cycles of azacitidine therapy or developed Grade III/IV infection before completing the third cycle.

RESULTS

Overall, 143 patients (62%) experienced serious infection, and in 94 patients (41%) infection occurred within the first 3 cycles. The following variables were found to have the most significant effect on the infectious risk in multivariate analysis: red blood cell transfusion dependency (odds ratio [OR], 2.38; 97.5% confidence interval [CI], 1.21-4.79), neutropenia <0.8 × 10

CONCLUSION

We selected a subset with high early risk for serious infection and worse clinical outcome among patients treated with azacitidine.

Identifiants

DOI: 10.1016/j.clml.2019.01.002 PMID: 30898482

pubmed: 30898482

pii: S2152-2650(18)31510-6

doi: 10.1016/j.clml.2019.01.002

pii:

doi:

Substances chimiques

Anti-Bacterial Agents 0

Antifungal Agents 0

Antimetabolites, Antineoplastic 0

Azacitidine M801H13NRU

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

264-274.e4