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J Hematol Oncol. 2012 Aug 1;5:44. doi: 10.1186/1756-8722-5-44.

Outcome of therapy-related myeloid neoplasms treated with azacitidine.

Author information

1
Istituto di Ematologia, Università Cattolica del Sacro Cuore, 00168, Roma, Italy.

Abstract

BACKGROUND:

Therapy-related myeloid neoplasms (t-MN), including myelodysplastic syndromes and acute myeloid leukemia (t-MDS and t-AML) are associated to clinical and biologic unfavorable prognostic features, including high levels of DNA methylation.

METHODS:

We retrospectively evaluated 50 t-MN patients (34 MDS and 16 AML) selected among all patients receiving azacitidine (AZA) at 10 Italian Hematology Centers. Patients had developed a t-MN at a median of 6.5 years (range 1.7- 29) after treatment of the primary tumor (hematological neoplasm, 27 patients; solid tumor, 23 patients).

RESULTS:

The overall response rate was 42% (complete remission: 10 patients, partial remission: 2 and hematological improvement: 8 patients) and was obtained after a median of 3 cycles (range 1-6). Median overall survival (OS) was 21 months (range 1-53.6+) from AZA start. OS was significantly better in patients with less than 20% blasts, in normal karyotype t-AML and when AZA was used as front-line treatment. This was confirmed by the multivariate analysis.

CONCLUSIONS:

This study reports efficacy of AZA in the largest series of therapy-related MN patients treated with 5-AZA. Our data show that blasts and karyotype maintain their important prognostic role in t-MN also in the azacitidine era.

PMID:
22853048
PMCID:
PMC3419605
DOI:
10.1186/1756-8722-5-44
[Indexed for MEDLINE]
Free PMC Article

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