title: Prognostic factors associated with disease progression and overall survival in patients with myelodysplastic syndromes treated with decitabine.
abstract: Decitabine improves overall survival (OS) and reduces risk of progression to acute myeloid leukemia (AML) in myelodysplastic syndromes (MDS). In this retrospective analysis of data from 2 decitabine studies (n = 162), hemoglobin level ≥ 10 g/dL, platelet count ≥ 50 10(3)/μL, and lack of chromosome 5 or 7 abnormalities predicted longer OS. Identifying potential prognostic factors for survival may guide decitabine treatment decisions and improve outcomes.
  
  
  BACKGROUND
  Myelodysplastic syndromes (MDS) progress to acute myeloid leukemia (AML) in approximately 30% of patients. Identification of risk factors for progression to AML and overall survival (OS) would help guide treatment decisions.
  
  
  METHODS
  We investigated prognostic factors for progression to AML and survival in 163 patients with MDS treated with decitabine 15 mg/m(2) over 3 hours every 8 hours for 3 days every 6 weeks (n = 74) or 20 mg/m(2) over 1 hour daily for 5 days every 4 weeks (n = 89).
  
  
  RESULTS
  Multivariate analysis of pooled baseline data revealed that only study effect was associated with progression to AML. A hemoglobin value at least 10 g/dL, platelet count at least 50 × 10(3)/μL, and lack of chromosome 5 or 7 abnormalities were associated with longer OS.
  
  
  CONCLUSIONS
  Patients with certain prognostic factors should be considered for other interventions in addition to decitabine treatment.
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. ejabbour@mdanderson.org
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Amber
authors.initials: A
authors.lastname: Fullmer
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Cortes
authors.forename: William
authors.initials: W
authors.lastname: Wierda
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001374:Azacitidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077209:Decitabine; D018450:Disease Progression; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000077209:Decitabine; D001374:Azacitidine