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Leuk Res. 2014 Apr;38(4):475-83. doi: 10.1016/j.leukres.2014.01.006. Epub 2014 Jan 18.

Azacitidine in CMML: matched-pair analyses of daily-life patients reveal modest effects on clinical course and survival.

Author information

1
3rd Medical Department with Hematology and Medical Oncology, Hemostasiology, Rheumatology and Infectiology, Laboratory for Immunological and Molecular Cancer Research, Paracelsus Medical University Hospital Salzburg, Austria.
2
University Hospital, Department of Hematology, Oncology and Clinical Immunology, Düsseldorf, Germany.
3
Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.
4
Department for Internal Medicine and Hematology, University Hospital, Graz, Austria.
5
Department for Internal Medicine IV, Hospital Wels-Grieskirchen, Austria.
6
Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Austria.
7
Department of Medicine I, Center of Hematology and Stem Cell Transplantation, Hemostasis and Medical Oncology, Elisabethinen Hospital Linz, Austria.
8
1st Department of Internal Medicine, Center for Oncology and Hematology, Wilhelminenspital, Vienna, Austria.
9
IIIrd Medical Department, Hanusch Hospital, Vienna, Austria.
10
Internal Medicine, Hospital Feldkirch, Austria.
11
5th Medical Department with Oncology und Palliative Medicine, Hietzing, Vienna, Austria.
12
Department for Internal Medicine, with Nephrology, Gastroenterology and Hepatology, Hematology and Medical Onkology, Intensive Care Unit, and Rheumatology, Klinikum Klagenfurt am Wörtersee, Pörtschach am Wörthersee, Austria.
13
Institute of Pathology, Paracelsus Medical University, Salzburg, Austria.
14
3rd Medical Department with Hematology and Medical Oncology, Hemostasiology, Rheumatology and Infectiology, Laboratory for Immunological and Molecular Cancer Research, Paracelsus Medical University Hospital Salzburg, Austria. Electronic address: r.greil@salk.at.

Abstract

Recent data suggest that azacitidine may be beneficial in CMML. We report on 48 CMML-patients treated with azacitidine. Overall response rates were high (70% according to IWG-criteria, including 22% complete responses). Monocyte count and cytogenetics adversely affected survival, whereas age, WHO-type, FAB-type, and spleen size did not. Matched-pair analyses revealed a trend for higher two-year-survival for azacitidine as compared to best supportive care (62% vs. 41%, p=0.067) and longer OS for azacitidine first-line vs. hydroxyurea first-line (p=0.072, median OS 27.7 vs. 6.2 months). This report reinforces existing evidence that azacitidine is safe and efficacious in both myelodysplastic and myeloproliferative CMML.

KEYWORDS:

Austrian Azacitidine Registry; Azacitidine; CMML; Chronic myelomonocytic leukemia; Matched-pair analysis

PMID:
24522248
DOI:
10.1016/j.leukres.2014.01.006
[Indexed for MEDLINE]
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