TY - JOUR
T1 - Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents
AU - Jabbour, Elias
AU - Strati, Paolo
AU - Cabrero, Monica
AU - O'Brien, Susan
AU - Ravandi, Farhad
AU - Bueso-Ramos, Carlos
AU - Wei, Qiao
AU - Hu, Jianhua
AU - Abi Aad, Simon
AU - Short, Nicholas J.
AU - Dinardo, Courtney
AU - Daver, Naval
AU - Kadia, Tapan
AU - Wierda, William
AU - Wei, Yue
AU - Colla, Simona
AU - Borthakur, Gautam
AU - Cortes, Jorge
AU - Estrov, Zeev
AU - Kantarjian, Hagop
AU - Garcia-Manero, Guillermo
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Two hundred and sixteen consecutive patients with MDS and abnormal karyotype treated with hypomethylating agents between 4/04 and 10/12 were reviewed. Median follow-up was 17 months. Using IWG criteria, best responses were complete response (CR) in 79 patients (37%), partial response (PR) in 4 (2%), and hematologic improvement (HI) in 10 (5%). Cytogenetic response (CyR) was achieved in 78 patients (36%): complete (CCyR) in 62 (29%) and partial in 16 (7%). CyR was achieved in 48 of 79 patients (61%) with CR, 1 of 14 (7%) with PR/HI, and in 29 of the 123 (24%) with no morphologic response. Median overall survival (OS) and leukemia-free survival (LFS) for patients with and without CCyR were 21 and 13 months (P =.007), and 16 and 9 months (P =.001), respectively. By multivariate analysis, the achievement of CCyR was predictive for better OS (HR = 2.1; P <.001). In conclusion, CyR occurs at a rate of 36% (complete in 29%) in patients with MDS treated with HMA and is not always associated with morphological response. The achievement of CCyR is associated with survival improvement and constitutes a major predictive factor for outcome particularly in patients without morphologic response. Therefore, the achievement of CCyR should be considered a milestone in the management of patients with MDS.
AB - Two hundred and sixteen consecutive patients with MDS and abnormal karyotype treated with hypomethylating agents between 4/04 and 10/12 were reviewed. Median follow-up was 17 months. Using IWG criteria, best responses were complete response (CR) in 79 patients (37%), partial response (PR) in 4 (2%), and hematologic improvement (HI) in 10 (5%). Cytogenetic response (CyR) was achieved in 78 patients (36%): complete (CCyR) in 62 (29%) and partial in 16 (7%). CyR was achieved in 48 of 79 patients (61%) with CR, 1 of 14 (7%) with PR/HI, and in 29 of the 123 (24%) with no morphologic response. Median overall survival (OS) and leukemia-free survival (LFS) for patients with and without CCyR were 21 and 13 months (P =.007), and 16 and 9 months (P =.001), respectively. By multivariate analysis, the achievement of CCyR was predictive for better OS (HR = 2.1; P <.001). In conclusion, CyR occurs at a rate of 36% (complete in 29%) in patients with MDS treated with HMA and is not always associated with morphological response. The achievement of CCyR is associated with survival improvement and constitutes a major predictive factor for outcome particularly in patients without morphologic response. Therefore, the achievement of CCyR should be considered a milestone in the management of patients with MDS.
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U2 - 10.1002/ajh.24650
DO - 10.1002/ajh.24650
M3 - Article
C2 - 28076892
AN - SCOPUS:85013001650
SN - 0361-8609
VL - 92
SP - 351
EP - 358
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 4
ER -