Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun;58(6):1325-1331.
doi: 10.1080/10428194.2016.1246726. Epub 2016 Oct 24.

Differential response to hypomethylating agents based on sex: a report on behalf of the MDS Clinical Research Consortium (MDS CRC)

Amy E DeZern  1 , Amer M Zeidan  2 , John Barnard  3 , Wesley Hand  1 , Najla Al Ali  4 , Francis Brown  5 , Cassie Zimmerman  3 , Gail J Roboz  6 , Guillermo Garcia-Manero  7 , David P Steensma  5 , Rami S Komrokji  4 , Mikkael A Sekeres  3 ; Evans MDS Clinical Research Consortium
Affiliations

Differential response to hypomethylating agents based on sex: a report on behalf of the MDS Clinical Research Consortium (MDS CRC)

Amy E DeZern et al. Leuk Lymphoma. 2017 Jun.

Abstract

First-line therapy for higher-risk myelodysplastic syndromes (MDS) includes decitabine (DAC) or azacitidine (AZA). Variables have not identified differential response rates between these. We assessed the influence of patient sex on outcomes including overall survival (OS) in 642 patients with higher-risk MDS treated with AZA or DAC. DAC-treated patients (35% of females, 31% of males) had marginally better OS than AZA-treated patients (p = .043), (median OS of 18.7 months versus 16.4 months), but the difference varied strongly by sex. Female patients treated with DAC had a longer median OS (21.1 months, 95% CI: 16.0-28.0) than female patients treated with AZA (13.2 months, 95% CI: 11.0-15.9; p = .0014), while for males there was no significant difference between HMAs (median OS 18.3 months with DAC versus 17.9 months for AZA, p = .59). The biological reason for this variability is unclear, but may be a consequence of differences in cytidine deaminase activity between men and women.

Keywords: MDS; Sex; azacitidine; decitabine; hypomethylating agents.

PubMed Disclaimer

Conflict of interest statement

Potential conflict of interest: Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2016.1246726.

Figures

Figure 1
Figure 1
OS by treatment with AZA or DAC by sex from time of disease diagnosis.
See this image and copyright information in PMC

Comment in

References

    1. Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114:937–951. - PubMed
    1. Cogle CR, Iannacone MR, Yu D, et al. High rate of uncaptured myelodysplastic syndrome cases and an improved method of case ascertainment. Leuk Res. 2014;38:71–75. - PubMed
    1. Sekeres MA. Epidemiology, natural history, and practice patterns of patients with myelodysplastic syndromes in 2010. JNCCN. 2011;9:57–63. - PubMed
    1. Sekeres MA. The myelodysplastic syndromes. Exp Opin Biol Ther. 2007;7:369–377. - PubMed
    1. Fenaux P, Mufti GJ, Hellstrom-Lindberg E, et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomized, open-label, phase III study. Lancet Oncol. 2009;10:223–232. - PMC - PubMed