title: Outcomes of patients with myelodysplastic syndromes who achieve stable disease after treatment with hypomethylating agents.
abstract: Treatment with hypomethylating agents (HMAs) improves overall survival (OS) in patients who achieve a response of stable disease (SD) or better (complete remission [CR], partial remission [PR], or hematologic improvement [HI]). It is not well established if patients who achieve SD at 4-6 months of therapy should be offered different therapies to optimize their response or continue with the same regimen. Clinical data were obtained from the MDS Clinical Research Consortium database. SD was defined as no evidence of progression and without achievement of any other responses. Of 291 patients treated with AZA or DAC, 55% achieved their best response (BR) at 4-6 months. Among patients with SD at 4-6 months, 29 (20%) achieved a better response at a later treatment time point. Younger patients with lower bone marrow blast percentages, and intermediate risk per IPSS-R were more likely to achieve a better response (CR, PR, or HI) after SD at 4-6 months. Patients with SD who subsequently achieved CR had superior OS compared to patients who remained with SD (28.1 vs. 14.4 months, respectively, p=.04). In conclusion, patients treated with HMAs who achieves CR after a SD status had longer survival with continuous treatment after 6 months.
authors.affiliation: Leukemia Program, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, United States.
authors.forename: Aziz
authors.initials: A
authors.lastname: Nazha
authors.affiliation: Leukemia Program, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, United States.
authors.forename: Mikkael A
authors.initials: MA
authors.lastname: Sekeres
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: John
authors.initials: J
authors.lastname: Barnard
authors.affiliation: Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
authors.forename: Najla H
authors.initials: NH
authors.lastname: Al Ali
authors.affiliation: Division of Hematology and Oncology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, United States.
authors.forename: Gail J
authors.initials: GJ
authors.lastname: Roboz
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States.
authors.forename: David P
authors.initials: DP
authors.lastname: Steensma
authors.affiliation: Division of Hematologic Malignancies of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
authors.forename: Amy E
authors.initials: AE
authors.lastname: DeZern
authors.affiliation: Leukemia Program, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, United States.
authors.forename: Cassie
authors.initials: C
authors.lastname: Zimmerman
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Elias J
authors.initials: EJ
authors.lastname: Jabbour
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Katrina
authors.initials: K
authors.lastname: Zell
authors.affiliation: Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
authors.forename: Alan F
authors.initials: AF
authors.lastname: List
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Hagop M
authors.initials: HM
authors.lastname: Kantarjian
authors.affiliation: Leukemia Program, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, United States.
authors.forename: Jaroslaw P
authors.initials: JP
authors.lastname: Maciejewski
authors.affiliation: Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States. Electronic address: Rami.komrokji@moffitt.org.
authors.forename: Rami S
authors.initials: RS
authors.lastname: Komrokji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001374:Azacitidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000077209:Decitabine; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000401:mortality; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000077209:Decitabine; D001374:Azacitidine
keywords: Hypomethylating agent; MDS; Response; Stable disease