Identification of predictive factors for overall survival at baseline and during azacitidine treatment in high-risk myelodysplastic syndrome patients treated in the clinical practice
Identification of predictive factors for overall survival at baseline and during azacitidine treatment in high-risk myelodysplastic syndrome patients treated in the clinical practice
复制标题
在临床实践中治疗的高危骨髓增生异常综合征患者中确定基线和阿扎胞苷治疗期间总体生存的预测因素
作者：
E. Scalzulli;Matteo Molica;Danilo Alunni Fegatelli;G. Colafigli;L. Rizzo;M. Mancini;F. Efficace;R. Latagliata;R. Foà;M. Breccia
在现实生活中，高危骨髓增生异常综合征（MDS）患者接受5-阿扎胞苷（5-AZA）治疗的结局在很大程度上仍然未知。我们评估了2003年9月至2017年1月期间在单一机构接受临床试验外治疗的110例MDS患者（IPSS中2/高）。中位治疗持续时间为9.5个周期。整个队列的1年总生存率（OS）为66.1%，2年为38.3%。在性别（p = 0.622）和基线年龄（< 65岁、65-75岁和> 75岁，p = 0.075）方面未观察到OS差异。根据IPSS-R，极高危组患者的2年OS（17%）低于中度组患者（64%，p < 0.001）。基线时输血独立性被认为是1年（66.8%）和2年OS（43.4%）的有利预后因素（p < 0.001）。4个周期后，持续骨髓原始细胞> 10%的患者预后较差，2年OS为9.4%（p = 0.002）。前4个周期内感染的发生影响2年OS（31.6% vs 58.3%，无感染患者，p = 0.032）。接受至少24个周期药物治疗的患者的5年OS为38.2%。该分析可识别基线或5-AZA治疗期间与不同2年OS相关的特征。
The outcome of high-risk myelodysplastic syndrome (MDS) patients treated with 5-azacitidine (5-AZA) in the real-life setting remains largely unknown. We evaluated 110 MDS patients (IPSS intermediate 2/high) treated outside of clinical trials at a single institution between September 2003 and January 2017. Median duration of therapy was 9.5 cycles. The overall survival (OS) of the whole cohort was 66.1% at 1 year and 38.3% at 2 years. No differences in terms of OS were observed with regard to gender (p = 0.622) and age at baseline (< 65 years, 65–75, and > 75 years, p = 0.075). According to the IPSS-R, the very high-risk group had an inferior 2-year OS (17%) compared with intermediate-group patients (64%, p < 0.001). Transfusion independency at baseline was identified as a favorable prognostic factor on 1-year (66.8%) and 2-year OS (43.4%) (p < 0.001). After four cycles, the persistence of bone marrow blasts > 10% identified patients with a worse outcome, with a 2-year OS of 9.4% (p = 0.002). The occurrence of an infection during the first four cycles impacted on the 2-year OS (31.6% vs 58.3% in patients without infections, p = 0.032). Patients receiving at least 24 cycles of the drug have a 5-year OS of 38.2%. This analysis allowed to identify features at baseline or during treatment with 5-AZA associated with a different 2-year OS.
与常规护理方案相比，阿扎西丁氨酸的疗效在治疗高风险的髓质发育异常综合征中：一项随机，开放标签的III期研究。
影响因子：
51.1
作者：
Fenaux, Pierre;Mufti, Ghulam J.;Hellstrom-Lindberg, Eva;Santini, Valeria;Finelli, Carlo;Giagounidis, Aristoteles;Schoch, Robert;Gattermann, Norbert;Sanz, Guillermo;List, Alan;Gore, Steven D.;Seymour, John F.;Bennett, John M.;Byrd, John;Backstrom, Jay;Zimmerman, Linda;McKenzie, David;Beach, C. L.;Silverman, Lewis R.
通讯作者：
Silverman, Lewis R.
影响因子：
20.3
作者：
Aimiuwu, Josephine;Wang, Hongyan;Chan, Kenneth K.
通讯作者：
Chan, Kenneth K.