The effects of azacitidine on the response and prognosis of myelodysplastic syndrome and acute myeloid leukemia involving a bone marrow erythroblast frequency of >50

• Published in: Leukemia Research Vol. 53; pp. 35 - 38
• Main Authors: Uchida, Tomoyuki, Hagihara, Masao, Hua, Jian, Inoue, Morihiro
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2017; Elsevier BV
• Subjects: Acute erythroleukemia; Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Antimetabolites, Antineoplastic - therapeutic use; Azacitidine; Azacitidine - pharmacology; Bone Marrow; Bone Marrow - pathology; Case-Control Studies; Erythroblasts; Erythroblasts - pathology; Female; Hematology, Oncology and Palliative Medicine; Humans; Leukemia, Myeloid, Acute; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - drug therapy; Male; Middle Aged; Myelodysplastic syndrome; Myelodysplastic Syndromes; Myelodysplastic Syndromes - diagnosis; Myelodysplastic Syndromes - drug therapy; Prognosis; Remission Induction; Remission Induction - methods; Retrospective Studies; WHO; Young Adult; Azacitidine; Myelodysplastic syndrome; Acute erythroleukemia; WHO
• ISSN: 0145-2126; 1873-5835; 1873-5835
• DOI: 10.1016/j.leukres.2016.11.012

•HI could be achieved even if erythroblasts were dominant in BM.•The overall survival was also not inferior in erythroblast-predominant group.•Azacitidine could be an option irrespective of the numbers of erythroid cells in BM. We reviewed the cases of 68 consecutive patients who were diagnosed with myelodysplastic syndrome (MDS, n=61) or acute erythroleukemia (AEL, n=7) according to the World Health Organization (WHO) 2008 criteria and had previously been treated with azacitidine, a hypomethylating agent. Fifteen MDS patients had bone marrow erythroblast frequencies of ≥50%, and 6 out of the 7 AEL patients were reclassified as MDS (refractory anemia with excess blasts [RAEB]-1: 1, RAEB-2: 5) according to the revised WHO 2016 criteria. There was no difference between the overall response ratio (41%), as determined by a hematological improvement in at least one of 3 lineages, of these erythroid rich patients and that of the control group, which comprised 46 MDS patients with bone marrow erythroblast frequencies of <50%. Three MDS patients that exhibited erythroid predominance achieved complete remission. The overall survival period (median: 15 months) of the erythroblast-predominant group was not inferior to that of the control group (median: 16 months). These results indicate that azacitidine is a promising treatment option for MDS/AEL irrespective of the numbers of erythroid cells in the patient’s bone marrow.