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

Lisa Pleyer¹, Ulrich Germing², Wolfgang R Sperr³, Werner Linkesch⁴, Sonja Burgstaller⁵, Reinhard Stauder⁶, Michael Girschikofsky⁷, Martin Schreder⁸, Michael Pfeilstocker⁹, Alois Lang¹⁰, Thamer Sliwa¹¹, Dietmar Geissler¹², Konstantin Schlick¹, Gudrun Placher-Sorko¹, Georg Theiler⁴, Josef Thaler⁵, Martina Mitrovic⁶, Daniel Neureiter¹³, Peter Valent³, Richard Greil¹⁴

Affiliations

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.

PMID: 24522248
DOI: 10.1016/j.leukres.2014.01.006

Free article

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

Lisa Pleyer et al. Leuk Res. 2014 Apr.

Free article

. 2014 Apr;38(4):475-83.

doi: 10.1016/j.leukres.2014.01.006. Epub 2014 Jan 18.

Authors

Affiliations

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.

PMID: 24522248
DOI: 10.1016/j.leukres.2014.01.006

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.

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Comment in

Optimizing treatments in rare diseases: will our evidence come from registry data?
Almeida AM. Almeida AM. Leuk Res. 2014 Apr;38(4):421-2. doi: 10.1016/j.leukres.2014.01.015. Epub 2014 Feb 6. Leuk Res. 2014. PMID: 24631371 No abstract available.

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

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

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