title: Use of 5-azacitidine for therapy-related myeloid neoplasms in patients with concomitant active neoplastic disease.
abstract: Patients diagnosed with therapy-related myeloid neoplasms (TRMN) with concomitant active neoplastic disorder (CAND) are usually proposed for best supportive care (BSC). We evaluated the feasibility of using 5-azacytidine (AZA) in this setting.
  
  
  
  All patients referred to Gustave Roussy between 2010 and 2015 for TRMN diagnosis (less than 30% blast) and eligible for AZA treatment were included. Patients with CAND proposed for BSC were also described. Patient's outcomes were analyzed based on the presence or not of a CAND.
  
  
  
  Fifty-two patients with TRMN were analyzed, including 19 patients with CAND (14 eligible for AZA) and 33 without CAND eligible for AZA. The 5 patients with CAND ineligible for AZA had a worst performance status (p=0.016) at diagnosis and a shorter overall survival (OS) (0.62 months). Baseline characteristics of patients eligible for AZA were similar in the 2 groups except a trend for best performance status in patients with CAND (p=0.06). Overall response rate (71.4% vs 60.3%), transfusion independence (50.0% vs 45.5%) and OS (12.7 months vs 10.8 months) were similar between patients with and without CAND respectively (p=ns).
  
  
  
  Here we report the feasibility and efficacy of AZA for selected patients with TRMN and a CAND.
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France.
authors.forename: M
authors.initials: M
authors.lastname: Annereau
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France.
authors.forename: C
authors.initials: C
authors.lastname: Willekens
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France.
authors.forename: L
authors.initials: L
authors.lastname: El Halabi
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France.
authors.forename: C
authors.initials: C
authors.lastname: Chahine
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de biologie et pathologie médicales, Villejuif F-94805, France.
authors.forename: V
authors.initials: V
authors.lastname: Saada
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de biologie et pathologie médicales, Villejuif F-94805, France.
authors.forename: N
authors.initials: N
authors.lastname: Auger
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France.
authors.forename: A
authors.initials: A
authors.lastname: Danu
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France.
authors.forename: E
authors.initials: E
authors.lastname: Bermudez
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France.
authors.forename: J
authors.initials: J
authors.lastname: Lazarovici
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France.
authors.forename: D
authors.initials: D
authors.lastname: Ghez
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de médecine oncologique, Villejuif F-94805, France.
authors.forename: A
authors.initials: A
authors.lastname: Leary
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de médecine oncologique, Villejuif F-94805, France.
authors.forename: B
authors.initials: B
authors.lastname: Pistilli
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France.
authors.forename: F
authors.initials: F
authors.lastname: Lemare
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France; Inserm UMR1170, Gustave Roussy, Université Paris-Saclay, Villejuif F-94805, France.
authors.forename: E
authors.initials: E
authors.lastname: Solary
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France; Inserm UMR1170, Gustave Roussy, Université Paris-Saclay, Villejuif F-94805, France.
authors.forename: S
authors.initials: S
authors.lastname: de Botton
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France.
authors.forename: R-P
authors.initials: RP
authors.lastname: Desmaris
authors.affiliation: Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France; Inserm UMR1170, Gustave Roussy, Université Paris-Saclay, Villejuif F-94805, France. Electronic address: jeanbaptiste.micol@gustaveroussy.fr.
authors.forename: J-B
authors.initials: JB
authors.lastname: Micol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001374:Azacitidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D001374:Azacitidine
keywords: 5-Azacytidine; Hypomethylating agents; Myeloid leukemias and dysplasias; Therapy-related acute myeloid leukemia; Therapy-related myelodysplastic syndromes; Therapy-related myeloid neoplasms