Azacitidine versus decitabine in patients with refractory anemia with excess blast-Results of multicenter study.
The present study aimed to compare the efficacy and safety of azacitidine and decitabine in patients with myelodysplastic syndrome (MDS). A total of 88 patients diagnosed with refractory anemia with excess blast (RAEB) treated with azacitidine (n=57) or decitabine (n=31) were evaluated. Comparisons between azacitidine and decitabine groups were performed in the whole cohort, and in a 1:1 propensity score-matched cohort in order to reduce the simple selection bias. Patients who received azacitidine or decitabine had comparable overall response rates in both the unmatched (49.1% vs. 64.5%, p=0.166) and the propensity-matched cohorts (52% vs. 68%, p=0.248). The cumulative incidence of AML transformation at one year was comparable between azacitidine and decitabine in the unmatched (24.0% vs. 31.3%, p=0.26) and in the propensity-matched cohorts (18.7% vs. 31.5%, p=0.11). There was no difference in terms of transfusion requirement, febrile neutropenia episodes or the need for antifungal use during the treatment cycles in the propensity-matched cohort. The median overall survival was 20.4 months for azacitidine and 16.8 months for decitabine (p=0.59). Finally, we found that at least a four-cycle treatment with any HMA was a favorable factor. In conclusion, both azacitidine and decitabine have similar efficacy and toxicity profiles in the treatment of MDS-RAEB.
Akdeniz University, School of Medicine, Department of Hematology, Antalya, Turkey. Electronic address: ozansalim@gmail.com.
Ozan
O
Salim
Marmara University, School of Medicine, Department of Hematology, Istanbul, Turkey.
Tayfur
T
Toptas
Akdeniz University, School of Medicine, Department of Hematology, Antalya, Turkey.
Esin
E
Avsar
Akdeniz University, School of Medicine, Department of Hematology, Antalya, Turkey.
Orhan Kemal
OK
Yucel
Koc University, School of Medicine, Department of Hematology, Istanbul, Turkey.
Erman
E
Ozturk
Koc University, School of Medicine, Department of Hematology, Istanbul, Turkey.
Burhan
B
Ferhanoglu
Kocaeli University, School of Medicine, Department of Hematology, Kocaeli, Turkey.
Ayfer
A
Geduk
Kocaeli University, School of Medicine, Department of Hematology, Kocaeli, Turkey.
Ozgur
O
Mehtap
Mersin University, School of Medicine, Department of Hematology, Mersin, Turkey.
Anil
A
Tombak
Mersin University, School of Medicine, Department of Hematology, Mersin, Turkey.
Eyup Naci
EN
Tiftik
Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey.
Burak
B
Deveci
Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey.
Erdal
E
Kurtoglu
Marmara University, School of Medicine, Department of Hematology, Istanbul, Turkey.
Osman
O
Kara
Marmara University, School of Medicine, Department of Hematology, Istanbul, Turkey.
Isik Kaygusuz
IK
Atagunduz
Marmara University, School of Medicine, Department of Hematology, Istanbul, Turkey.
Tulin Firatli
TF
Tuglular
Akdeniz University, School of Medicine, Department of Hematology, Antalya, Turkey.
Levent
L
Undar
D000368:Aged; D000754:Anemia, Refractory, with Excess of Blasts / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D001374:Azacitidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016913:Blood Component Transfusion / Q000706:statistics & numerical data; D002471:Cell Transformation, Neoplastic; D000077209:Decitabine; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes; D018579:Patient Selection; D057216:Propensity Score; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate
D000964:Antimetabolites, Antineoplastic; D000077209:Decitabine; D001374:Azacitidine
Azacitidine; Comparison; Decitabine; MDS