title: Azacitidine in the front-line treatment of therapy-related myeloid neoplasms: a multicenter case series.
abstract: OBJECTIVE
  A continued increase in the incidence of therapy-related myeloid neoplasms (t-MN) is expected due to the improvement of chemotherapeutic treatments for solid and haematological malignancies. The use of 5-azacytidine (AZA) is emerging in these patients. We, therefore, analyzed the outcome of patients with t-MN ineligible for intensive chemotherapy treated in the front-line with AZA.
  
  
  METHODS
  We retrospectively collected clinical data from consecutive patients with t-MN treated in the front-line with AZA at five Haematology Centers. Response to therapy, overall survival (OS) and safety were considered.
  
  
  RESULTS
  The overall response rate was of 35.7% with a median OS of 9.6 months. Patients who were heavily pre-treated for their primary malignancy (more than 3 lines of chemotherapy) presented a significant inferior OS (4.9 months). The principal reported toxicity was haematological with severe infections occurring in a minority of patients. Fatigue was the most common extra-haematological toxicity.
  
  
  CONCLUSIONS
  New aspects emerged on the management of t-MN. AZA may represent a reasonable choice for patients ineligible for intensive treatment, with the exception of heavily pre-treated patients who presented -anyway- a worse outcome.
authors.affiliation: Haematology Unit, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy carlaminoia@libero.it.
authors.forename: Carla
authors.initials: C
authors.lastname: Minoia
authors.affiliation: Haematology Unit, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Sgherza
authors.affiliation: Haematology Unit, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Loseto
authors.affiliation: Haematology Unit, "G. Panico" Hospital, Tricase, Lecce, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Greco
authors.affiliation: Haematology Unit, "Dimiccoli" Hospital, Barletta, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Buquicchio
authors.affiliation: Haematology Unit, "Antonio Perrino" Hospital, Brindisi, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Merchionne
authors.affiliation: Internal Medicine Unit, Hematology department, "S. Chiara di Trento" Hospital, Trento, Italy.
authors.forename: Chandrakala
authors.initials: C
authors.lastname: Toldo
authors.affiliation: Registro Tumori Puglia, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Galise
authors.affiliation: Haematology Unit, "Antonio Perrino" Hospital, Brindisi, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Melpignano
authors.affiliation: Haematology Unit, "Dimiccoli" Hospital, Barletta, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.affiliation: Haematology Unit, "G. Panico" Hospital, Tricase, Lecce, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pavone
authors.affiliation: Haematology Unit, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Guarini
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001374:Azacitidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced / Q000188:drug therapy* / Q000401:mortality; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine
keywords: Therapy-related myeloid neosplasm; azacitidine; outcome; safety