title: The effects of azacitidine on the response and prognosis of myelodysplastic syndrome and acute myeloid leukemia involving a bone marrow erythroblast frequency of >50.
abstract: We reviewed the cases of 68 consecutive patients who were diagnosed with myelodysplastic syndrome (MDS, n=61) or acute erythroleukemia (AEL, n=7) according to the World Health Organization (WHO) 2008 criteria and had previously been treated with azacitidine, a hypomethylating agent. Fifteen MDS patients had bone marrow erythroblast frequencies of ≥50%, and 6 out of the 7 AEL patients were reclassified as MDS (refractory anemia with excess blasts [RAEB]-1: 1, RAEB-2: 5) according to the revised WHO 2016 criteria. There was no difference between the overall response ratio (41%), as determined by a hematological improvement in at least one of 3 lineages, of these erythroid rich patients and that of the control group, which comprised 46 MDS patients with bone marrow erythroblast frequencies of <50%. Three MDS patients that exhibited erythroid predominance achieved complete remission. The overall survival period (median: 15 months) of the erythroblast-predominant group was not inferior to that of the control group (median: 16 months). These results indicate that azacitidine is a promising treatment option for MDS/AEL irrespective of the numbers of erythroid cells in the patient's bone marrow.
authors.affiliation: Depatment of Hematology, Eiju General Hospital, Higashi-Ueno 2-23-16, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Depatment of Hematology, Eiju General Hospital, Higashi-Ueno 2-23-16, Japan. Electronic address: hagihara@eijuhp.com.
authors.forename: Masao
authors.initials: M
authors.lastname: Hagihara
authors.affiliation: Depatment of Hematology, Eiju General Hospital, Higashi-Ueno 2-23-16, Japan.
authors.forename: Jian
authors.initials: J
authors.lastname: Hua
authors.affiliation: Depatment of Hematology, Eiju General Hospital, Higashi-Ueno 2-23-16, Japan.
authors.forename: Morihiro
authors.initials: M
authors.lastname: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001374:Azacitidine / Q000494:pharmacology*; D001853:Bone Marrow / Q000473:pathology; D016022:Case-Control Studies; D004900:Erythroblasts / Q000473:pathology*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy*; D011379:Prognosis; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D001374:Azacitidine
keywords: Acute erythroleukemia; Azacitidine; Myelodysplastic syndrome; WHO