Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries

被引：12

作者：

Diez-Campelo, Maria ^{[1
,2
]}

Lorenzo, Jose I. ^{[3
]}

Itzykson, Raphael ^{[4
,5
]}

Rojas, Silvia M. ^{[1
]}

Berthon, Celine ^{[6
]}

Luno, Elisa ^{[7
]}

Beyne-Rauzy, Odile ^{[8
]}

Perez-Oteyza, Jaime ^{[9
]}

Vey, Norbert ^{[10
]}

Bargay, Joan ^{[11
]}

Park, Sophie ^{[12
]}

Cedena, Teresa ^{[13
]}

Bordessoule, Dominique ^{[14
]}

Munoz, Juan A. ^{[15
]}

Gyan, Emmanuel ^{[16
]}

Such, Esperanza ^{[3
]}

Visanica, Sorin ^{[17
]}

Lopez-Cadenas, Felix ^{[1
]}

de Botton, Stephane ^{[18
]}

Hernandez-Rivas, Jesus M. ^{[1
,2
]}

Ame, Shanti ^{[19
]}

Stamatoullas, Aspasia ^{[20
]}

Delaunay, Jacques ^{[21
]}

Salanoubat, Celia ^{[22
]}

Isnard, Francoise ^{[23
]}

Guieze, Romain ^{[24
]}

Perez Guallar, Joan ^{[25
]}

Badiella, Llorenc ^{[25
]}

Sanz, Guillermo ^{[3
]}

Canizo, Consuelo ^{[1
,2
]}

Fenaux, Pierre ^{[4
,5
]}

机构：

[1] Hosp Univ Salamanca, Haematol, Salamanca, Spain

[2] Inst Biomed Res Salamanca IBSAL, Salamanca, Spain

[3] Hosp Univ & Politecn La Fe, Dept Haematol, Valencia, Spain

[4] St Louis, AP HP, Serv Hematol, Paris, France

[5] Paris Diderot Univ, Paris, France

[6] CHRU Lille, Malad Sang, Hop Huriez, Lille, France

[7] Hosp Univ Cent Asturias, Haematol, Oviedo, Spain

[8] CHU Purpan, Haematol, Toulouse, France

[9] Hosp Sanchinarro Norte, Haematol, Madrid, Spain

[10] Inst Paoli Calmettes, Dept Haematol, Marseille, France

[11] Hosp Sont Llatzer, Palma De Mallorca, Spain

[12] CHU Grenoble, Clin Univ Hematol, Haematol, Grenoble, France

[13] Hosp 12 Octubre, Madrid, Spain

[14] Serv Hematol Clin & Therapie Cellulaire, Unite Rech Clin, Limoges, France

[15] Hosp Puerta del Mar, Cadiz, Spain

[16] Univ Tours, CHRU Tours, Team UMR CNRS 7292 3, Serv Hematol & Therapie Cellulaire, Tours, France

[17] Hop Bon Secours, Hematol, Metz, Thionville, France

[18] Inst Gustave Roussy, Hematol, Villejuif, France

[19] Hop Civil, Dept Haematol, Strasbourg, France

[20] Ctr Henri Becquerel, Dept Haematol, Rouen, France

[21] CHU Nantes, Dept Haematol, Nantes, France

[22] Hop Corbeil, Corbeil Essonnes, France

[23] Univ Paris 06, St Antoine, AP HP, Dept Haematol, Paris, France

[24] CHU Estaing, Hematol, Clermont Ferrand, France

[25] Univ Autonoma Barcelona, Dept Applicat Stat, Barcelona, Spain

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2018年 / 181卷 / 03期

关键词：

azacitidine; chromosome; 7; abnormalities; time-dependent analysis; high risk MDS; ACUTE MYELOID-LEUKEMIA; MYELODYSPLASTIC SYNDROMES; SCORING SYSTEM; PROGNOSIS;

D O I：

10.1111/bjh.15190

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Treatment with azacitidine (AZA) has been suggested to be of benefit for higher-risk myelodysplastic syndrome (HR-MDS) patients with chromosome 7 abnormalities (Abn 7). This retrospective study of 235 HR-MDS patients with Abn 7 treated with AZA (n=115) versus best supportive care (BSC; n=120), assessed AZA treatment as a time-varying variable in multivariable analysis. A Cox Regression model with time-interaction terms of overall survival (OS) at different time points confirmed that, while chromosome 7 cytogenetic categories (complex karyotype [CK] versus non-CK) and International Prognostic Scoring System risk (high versus intermediate-2) retained poor prognosis over time, AZA treatment had a favourable impact on OS during the first 3years of treatment compared to BSC (Hazard ratio [HR] 05 P<0001 at 1year, 07 P=0019 at 2years; 073 P=0029 at 3years). This benefit was present in all chromosome 7 categories, but tended to be greater in patients with CK (risk reduction of 82%, 68% and 53% at 1, 3 and 6months in CK patients; 79% at 1month in non-CK patients, P<005 for all). AZA also significantly improved progression-free survival (P<001). This study confirms a time-dependent benefit of AZA on outcome in patients with HR-MDS and cytogenetic abnormalities involving chromosome 7, especially for those with CK.

引用

页码：350 / 359

页数：10

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