TY - JOUR
T1 - Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities
T2 - a retrospective comparison of GESMD and GFM registries
AU - Díez-Campelo, María
AU - Lorenzo, Jose I.
AU - Itzykson, Raphael
AU - Rojas, Silvia M.
AU - Berthon, Céline
AU - Luño, Elisa
AU - Beyne-Rauzy, Odile
AU - Perez-Oteyza, Jaime
AU - Vey, Norbert
AU - Bargay, Joan
AU - Park, Sophie
AU - Cedena, Teresa
AU - Bordessoule, Dominique
AU - Muñoz, Juan A.
AU - Gyan, Emmanuel
AU - Such, Esperanza
AU - Visanica, Sorin
AU - López-Cadenas, Félix
AU - de Botton, Stéphane
AU - Hernández-Rivas, Jesús M.
AU - Ame, Shanti
AU - Stamatoullas, Aspasia
AU - Delaunay, Jacques
AU - Salanoubat, Celia
AU - Isnard, Françoise
AU - Guieze, Romain
AU - Pérez Guallar, Joan
AU - Badiella, Llorenc
AU - Sanz, Guillermo
AU - Cañizo, Consuelo
AU - Fenaux, Pierre
N1 - Publisher Copyright:
© 2018 John Wiley & Sons Ltd
PY - 2018/5/1
Y1 - 2018/5/1
N2 - 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 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P < 0·001 at 1 year, 0·7 P = 0·019 at 2 years; 0·73 P = 0·029 at 3 years). 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 6 months in CK patients; 79% at 1 month in non-CK patients, P < 0·05 for all). AZA also significantly improved progression-free survival (P < 0·01). 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.
AB - 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 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P < 0·001 at 1 year, 0·7 P = 0·019 at 2 years; 0·73 P = 0·029 at 3 years). 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 6 months in CK patients; 79% at 1 month in non-CK patients, P < 0·05 for all). AZA also significantly improved progression-free survival (P < 0·01). 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.
KW - azacitidine
KW - chromosome 7 abnormalities
KW - high risk MDS
KW - time-dependent analysis
UR - http://www.scopus.com/inward/record.url?scp=85045895512&partnerID=8YFLogxK
U2 - 10.1111/bjh.15190
DO - 10.1111/bjh.15190
M3 - Article
C2 - 29611196
AN - SCOPUS:85045895512
SN - 0007-1048
VL - 181
SP - 350
EP - 359
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 3
ER -