Outcome of therapy-related myeloid neoplasms treated with azacitidine

Luana Fianchi, Marianna Criscuolo, Monia Lunghi, Gianluca Gaidano, Massimo Breccia, Alessandro Levis, Carlo Finelli, Valeria Santini, Pellegrino Musto, Esther N. Oliva, Pietro Leoni, Antonietta Aloe Spiriti, Francesco Dal, Stefan Hohaus, Livio Pagano, Giuseppe Leone, Maria Teresa Voso

Research output: Contribution to journalArticle

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 50t-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 6.5years (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 21months (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.

Original languageEnglish
Article number44
JournalJournal of Hematology and Oncology
Volume5
DOIs
Publication statusPublished - 2012

Keywords

  • Hypomethylating agents
  • Therapy related myeloid neoplasms

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research
  • Molecular Biology

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    Fianchi, L., Criscuolo, M., Lunghi, M., Gaidano, G., Breccia, M., Levis, A., Finelli, C., Santini, V., Musto, P., Oliva, E. N., Leoni, P., Spiriti, A. A., Dal, F., Hohaus, S., Pagano, L., Leone, G., & Voso, M. T. (2012). Outcome of therapy-related myeloid neoplasms treated with azacitidine. Journal of Hematology and Oncology, 5, [44]. https://doi.org/10.1186/1756-8722-5-44