title: Multivariable time-dependent analysis of the impact of azacitidine in patients with lower-risk myelodysplastic syndrome and unfavorable specific lower-risk score.
abstract: Scoring systems for lower-risk myelodysplastic syndrome (LR-MDS) recognize patients with a poorer than expected outcome. This study retrospectively analyzes the role of azacitidine in LR-MDS with adverse risk score and compared to an historical cohort treated with best supportive care or erythropoiesis-stimulating agents. Overall response to AZA was 40%. One and 2-year probabilities of survival were 62% and 45% for AZA vs. 25% and 11% (P=10(-4)). In a multivariable time-dependent analysis, response to AZA (CR/PR/HI) was associated with an improved survival (HR=0.234, 95% CI, 0.063-0.0863; P=0.029). Thrombocytopenia (<50 × 10(9)L(-1)) is confirmed as an adverse parameter in LR-MDS (HR=1.649, 95% CI, 1.012-2.687; P=0.045).
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla. Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Spain. Electronic address: josef.falantes.sspa@juntadeandalucia.es.
authors.forename: Jose
authors.initials: J
authors.lastname: Falantes
authors.affiliation: Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors.forename: Regina García
authors.initials: RG
authors.lastname: Delgado
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla. Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Calderón-Cabrera
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla. Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Márquez-Malaver
authors.affiliation: Hospital Universitario Vall d' Hebron, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Valcarcel
authors.affiliation: Hospital Universitario de Guadalajara, Guadalajara, Spain.
authors.forename: Dunia
authors.initials: D
authors.lastname: de Miguel
authors.affiliation: Hospital Carlos Haya, Málaga, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Bailén
authors.affiliation: Hospital Son Llatzer, Palma de Mallorca, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Bargay
authors.affiliation: Hospital Universitario Central de Asturias, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bernal
authors.affiliation: Hospital Clínico Universitario de Salamanca, Salamanca, Spain.
authors.forename: Jose R
authors.initials: JR
authors.lastname: González-Porras
authors.affiliation: Hospital Clínico Universitario de Valencia, Valencia, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Tormo
authors.affiliation: Hospital General de León, León, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Ramos
authors.affiliation: Hospital Doctor Peset, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Andreu
authors.affiliation: Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Xicoy
authors.affiliation: Hospital Clinic, Barcelona, Spain.
authors.forename: Benet
authors.initials: B
authors.lastname: Nomdedeu
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.affiliation: Hospital Reina Sofía, Córdoba, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sánchez
authors.affiliation: Hospital Juan Ramón Jiménez, Huelva, Spain(1).
authors.forename: Antonio Fernández
authors.initials: AF
authors.lastname: Jurado
authors.affiliation: Hospital Universitario de la Ribera, Valencia, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Bonanad
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla. Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Spain.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Pérez-Simón
authors.affiliation: Hospital Universitario y Politécnico La Fe, Valencia, Spain(2).
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D001374:Azacitidine / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine
keywords: Azacitidine; Lower-risk myelodysplastic syndrome; Outcome