Retrospective analysis of prognostic factors associated with response and overall survival by baseline marrow blast percentage in patients with myelodysplastic syndromes treated with decitabine.

Abstract

BACKGROUND:

After the World Health Organization (WHO) changed the definition of acute myeloid leukemia (AML) to ≥ 20% blasts, the International Working Group (IWG) response criteria for myelodysplasia were updated. This retrospective analysis evaluated response to decitabine using updated IWG criteria in patients pooled from 2 decitabine trials.

PATIENTS AND METHODS:

Outcomes for patients with myelodysplastic syndrome (MDS) with baseline marrow blasts ≥ 20% and < 30% (RAEB-t group) and < 20% (MDS group) were compared.

RESULTS:

Patients with RAEB-t (n = 26) had a significantly shorter time from diagnosis to study treatment (7.3 vs. 18.3 months), a higher International Prognostic Scoring System (IPSS) risk (77% vs. 16% high-risk patients), and lower median baseline platelet count (62.3 vs. 112.7 × 10(3)/μL) vs. patients with MDS (n = 157), yet no significant difference in overall response rate (ORR) (15.4% vs. 28.0%). Patients with MDS had better duration of response (9.9 vs. 5 months; P = .024) and overall survival (OS) (16.6 vs. 9.0 months; P = .021) compared with patients with RAEB-t.

CONCLUSION:

Decitabine is active in and may benefit patients with > 20% blasts (RAEB-t).

• Authors: Elias Jabbour, Hagop Kantarjian, Susan O'Brien, Tapan Kadia, Asifa Malik, Mary-Alma Welch, Angela Teng, Jorge Cortes, Farhad Ravandi, Guillermo Garcia-Manero
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 13 Issue 5 Pg. 592-6 (Oct 2013) ISSN: 2152-2669 [Electronic] United States
• PMID: 23790798 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Antimetabolites, Antineoplastic
• Decitabine
• Azacitidine

Topics

• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (therapeutic use)
• Azacitidine (analogs & derivatives, therapeutic use)
• Bone Marrow (pathology)
• Decitabine
• Female
• Humans
• Male
• Middle Aged
• Myelodysplastic Syndromes (drug therapy, mortality, pathology)
• Prognosis
• Retrospective Studies
• Treatment Outcome