title: Does addition of erythropoiesis stimulating agents improve the outcome of higher-risk myelodysplastic syndromes treated with azacitidine?
abstract: We studied a retrospective cohort of 282 higher-risk MDS treated with azacitidine, including 32 patients who concomitantly received an ESA for a median of 5.8 months after azacitidine onset. Forty-four percent of ESA and 29% of no-ESA patients reached HI-E (p=0.07); 48% and 20% achieved transfusion independence (p=0.01). Median OS was 19.6 months in the ESA and 11.9 months in the no-ESA groups (p=0.04). Addition of an ESA significantly improved OS (p=0.03) independently of azacitidine schedule and duration, and of our proposed azacitidine risk score (Blood 2011;117:403-11). Adding an ESA to azacitidine in higher-risk MDS should be studied prospectively.
authors.affiliation: Service d'Hématogie Clinique Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, and Paris 13 University, France.
authors.forename: R
authors.initials: R
authors.lastname: Itzykson
authors.forename: S
authors.initials: S
authors.lastname: Thépot
authors.forename: O
authors.initials: O
authors.lastname: Beyne-Rauzy
authors.forename: S
authors.initials: S
authors.lastname: Ame
authors.forename: F
authors.initials: F
authors.lastname: Isnard
authors.forename: F
authors.initials: F
authors.lastname: Dreyfus
authors.forename: C
authors.initials: C
authors.lastname: Salanoubat
authors.forename: A L
authors.initials: AL
authors.lastname: Taksin
authors.forename: Y
authors.initials: Y
authors.lastname: Chelgoum
authors.forename: C
authors.initials: C
authors.lastname: Berthon
authors.forename: J V
authors.initials: JV
authors.lastname: Malfuson
authors.forename: L
authors.initials: L
authors.lastname: Legros
authors.forename: N
authors.initials: N
authors.lastname: Vey
authors.forename: P
authors.initials: P
authors.lastname: Turlure
authors.forename: C
authors.initials: C
authors.lastname: Gardin
authors.forename: S
authors.initials: S
authors.lastname: Boehrer
authors.forename: L
authors.initials: L
authors.lastname: Ades
authors.forename: P
authors.initials: P
authors.lastname: Fenaux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D001374:Azacitidine / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D006397:Hematinics; D001374:Azacitidine