Characteristics of Long-Term Survival in Patients With Myelodysplastic Syndrome Treated With 5-Azacyditine: Results From the Hellenic 5-Azacytidine Registry.


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:
02 2020
Historique:
received: 17 05 2019
revised: 07 08 2019
accepted: 20 09 2019
pubmed: 31 12 2019
medline: 13 5 2021
entrez: 30 12 2019
Statut: ppublish

Résumé

Hypomethylating agents have altered the prognosis of myelodysplastic syndrome (MDS) so that long-term survival is now a feasible treatment goal. We analyzed data from patients with MDS treated with 5-azacytidine recorded in the Hellenic 5-azacytidine registry. We divided patients, on the basis of their survival after 5-azacytidine initiation (OS Categorization per the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R), and World Health Organization-based prognostic scoring system (WPSS) was found to predict long-term survival, while multivariate analysis revealed that response to 5-azacytidine was the strongest predictor of long-term survival. Nevertheless, patients with hematologic improvement (HI) and stable disease (SD) were equally distributed in the groups of short- and long-term survival. SD should not be considered a poor treatment response and should not be grouped with failure, while HI offers similar prognosis to SD and thus should not be grouped with complete and partial remission. Patients with SD should continue treatment with 5-azacytidine.

Sections du résumé

BACKGROUND
Hypomethylating agents have altered the prognosis of myelodysplastic syndrome (MDS) so that long-term survival is now a feasible treatment goal.
PATIENTS AND METHODS
We analyzed data from patients with MDS treated with 5-azacytidine recorded in the Hellenic 5-azacytidine registry. We divided patients, on the basis of their survival after 5-azacytidine initiation (OS
RESULTS
Categorization per the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R), and World Health Organization-based prognostic scoring system (WPSS) was found to predict long-term survival, while multivariate analysis revealed that response to 5-azacytidine was the strongest predictor of long-term survival. Nevertheless, patients with hematologic improvement (HI) and stable disease (SD) were equally distributed in the groups of short- and long-term survival.
CONCLUSION
SD should not be considered a poor treatment response and should not be grouped with failure, while HI offers similar prognosis to SD and thus should not be grouped with complete and partial remission. Patients with SD should continue treatment with 5-azacytidine.

Identifiants

pubmed: 31884152
pii: S2152-2650(19)32001-4
doi: 10.1016/j.clml.2019.09.614
pii:
doi:

Substances chimiques

Antimetabolites, Antineoplastic 0
Azacitidine M801H13NRU

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

114-121

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Panagiotis T Diamantopoulos (PT)

Hematology Unit, First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: pandiamantopoulos@gmail.com.

Vasiliki Pappa (V)

Hematology Division, Second Department of Internal Medicine, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Argiris Symeonidis (A)

Department of Internal Medicine, University Hospital of Patras, Rio, Greece.

Ioannis Kotsianidis (I)

Department of Hematology, University Hospital of Alexandroupolis, Alexandroupoli, Greece.

Athanasios Galanopoulos (A)

Department of Clinical Hematology, "G. Gennimatas" District General Hospital, Athens, Greece.

Helen Papadaki (H)

Haematology Laboratory, School of Medicine, University of Crete, Crete, Greece.

Achilles Anagnostopoulos (A)

Hematology Department, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece.

George Vassilopoulos (G)

Department of Hematology, Larissa University Hospital, University of Thessalia, Larissa, Greece.

Panagiotis Zikos (P)

Department of Hematology, "St Andrew" General Hospital, Patras, Greece.

Eleftheria Hatzimichael (E)

Department of Haematology, University of Ioannina, Ioannina, Greece.

Maria Papaioannou (M)

Hematology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece.

Aekaterini Megalakaki (A)

Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece.

Maria Kotsopoulou (M)

Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece.

Panagiotis Repousis (P)

Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece.

Maria Dimou (M)

First Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Eleni Solomou (E)

Department of Internal Medicine, University Hospital of Patras, Rio, Greece.

Charalampos Pontikoglou (C)

Haematology Laboratory, School of Medicine, University of Crete, Crete, Greece.

Georgios Kyriakakis (G)

Hematology Unit, First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Dimitrios Tsokanas (D)

Department of Clinical Hematology, "G. Gennimatas" District General Hospital, Athens, Greece.

Menelaos-Konstantinos Papoutselis (MK)

Department of Hematology, University Hospital of Alexandroupolis, Alexandroupoli, Greece.

Sotirios Papageorgiou (S)

Hematology Division, Second Department of Internal Medicine, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Alexandra Kourakli (A)

Department of Internal Medicine, University Hospital of Patras, Rio, Greece.

Panayiotis Panayiotidis (P)

First Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Nora-Athina Viniou (NA)

Hematology Unit, First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

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Classifications MeSH