title: Azacitidine in the treatment of therapy related myelodysplastic syndrome and acute myeloid leukemia (tMDS/AML): a report on 54 patients by the Groupe Francophone Des Myelodysplasies (GFM).
abstract: The effect of azacitidine (AZA) in therapy related MDS and AML (t-MDS/AML) is not well established. 54 patients (42 t-MDS and 12 t-AML), 71% of whom had complex karyotype, received AZA for at least one cycle (median 4 cycles). The overall response rate (ORR) was 39% in the whole cohort and 62% in patients who received ≥4 cycles. One, 2 and 3 year OS was 36%, 14% and 8% respectively. Female gender (p=0.01) and ECOG 0-1 (p=0.04) were associated with significantly better OS, while karyotype and marrow blast percentage had no significant impact. By comparison with de novo MDS/AML treated in the same program, t-MDS/AML had a similar response rate (38% vs 45% in de novo MDS/AML, p=0.53), but significantly shorter OS (2 year OS of 14% vs 33.9%, p=0.0005). However, in a multivariate analysis performed in all patients (de novo and therapy related cases), only complex karyotype and high IPSS, and not etiology (i.e. de novo versus therapy related), had a significant impact on OS. Nine (15%) patients received allogeneic stem cell transplantation, 4 of whom were still alive.
authors.affiliation: Groupe Francophone des Myelodysplasies, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Bally
authors.forename: Sylvain
authors.initials: S
authors.lastname: Thépot
authors.forename: Bruno
authors.initials: B
authors.lastname: Quesnel
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.forename: Francois
authors.initials: F
authors.lastname: Dreyfus
authors.forename: Jehane
authors.initials: J
authors.lastname: Fadlallah
authors.forename: Pascal
authors.initials: P
authors.lastname: Turlure
authors.forename: Stephane
authors.initials: S
authors.lastname: de Botton
authors.forename: Caroline
authors.initials: C
authors.lastname: Dartigeas
authors.forename: Benoit
authors.initials: B
authors.lastname: de Renzis
authors.forename: Raphael
authors.initials: R
authors.lastname: Itzykson
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Lionel
authors.initials: L
authors.lastname: Adès
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D024221:Antineoplastic Protocols; D001374:Azacitidine / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005602:France; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000401:mortality; D011832:Radiation Injuries / Q000188:drug therapy / Q000401:mortality; D012955:Societies, Medical; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine