title: Azacitidine treatment for patients with myelodysplastic syndrome and acute myeloid leukemia with chromosome 3q abnormalities.
abstract: Acute Myeloid Leukemia (AML) and myelodysplasia (MDS) with chromosome 3q abnormalities have a dismal outcome either untreated or with conventional treatments. Azacitidine (AZA) is now considered as the standard of care in high-risk MDS and oligoblastic AML patients. The objective of this study was to evaluate the impact of azacitine treatment in this cytogenetic subgroup. We report here a multicentre retrospective study of 157 patients treated with AZA for AML/MDS with chromosome 3q abnormalities and 27 patients with isolated EVI-1 overexpression. Median age was 65 years, 40 patients (25%) had inv(3)(q21q26.2) or t(3;3)(q21;q26.2), 36 patients (23%) had other balanced 3q26 rearrangements, 8 patients (5%) had balanced 3q21 rearrangements and 73 patients (46%) had other 3q abnormalities. The overall response rate was 50% (29% CR). Median overall survival was 10.6 months. By multivariate analysis, patients with lower bone marrow blast counts, higher platelet counts, non-complex cytogenetics, and absence of prior treatment with intensive chemotherapy had a better outcome. 27 patients were allo-transplanted and achieved a 21-month median OS. Balanced 3q21 translocations were associated with a better response rate and overall survival. Outcome of patients with isolated EVI-1 overexpression was comparable to that of patients with chromosome 3q lesions. Thus, AML/MDS patients with 3q abnormalities appear to be a heterogeneous group in their response to AZA, and AZA may represent a suitable option in particular as a bridge to allogeneic transplantation.
authors.affiliation: Hematology Department, Institut Paoli-Calmettes, Marseille, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Wanquet
authors.affiliation: Hematology Department, Institut Paoli-Calmettes, Marseille, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Prebet
authors.affiliation: Hematology Department, Centre Hospitalo Universitaire De Lille, Lille, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Berthon
authors.affiliation: Hematology Department, Assistance Publique-Hôpitaux De Paris (APHP), Hopital Saint Louis, Paris and Paris 7 University, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Sebert
authors.affiliation: Hematology Department, Centre Hospitalo Universitaire De Nice, Nice, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Roux
authors.affiliation: Hematology Department, King's College, London, United Kingdom.
authors.forename: Austin
authors.initials: A
authors.lastname: Kulasekararaj
authors.affiliation: Hematology Department, Insitut Gustave Roussy, Villejuif, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Micol
authors.affiliation: Biostatistics Department, Institut paoli-Calmettes, Marseille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Esterni
authors.affiliation: Hematology Department, Assistance Publique-Hôpitaux De Paris (APHP), Hopital Saint Louis, Paris and Paris 7 University, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Itzykson
authors.affiliation: Hematology Department, Hopital Avicenne (APHP) and Paris 13 University, Bobigny, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Thepot
authors.affiliation: Hematology Department, Centre Hospitalo Universitaire De Toulouse, Toulouse, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Recher
authors.affiliation: Hematology Department, Centre Hospitalo Universitaire De Nantes, Nantes, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Delaunay
authors.affiliation: Hematology Department, Hopital Cochin (APHP) and Paris 5 University, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Dreyfus
authors.affiliation: Hematology Department, King's College, London, United Kingdom.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Mufti
authors.affiliation: Hematology Department, Assistance Publique-Hôpitaux De Paris (APHP), Hopital Saint Louis, Paris and Paris 7 University, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.affiliation: Hematology Department, Institut Paoli-Calmettes, Marseille, France.|Aix Marseille University, Marseille, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D001374:Azacitidine / Q000008:administration & dosage*; D001752:Blast Crisis / Q000235:genetics / Q000401:mortality / Q000628:therapy; D002869:Chromosome Aberrations; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate
chemical_list: D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine