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Comparison of various criteria in predicting treatment response and prognosis of patients with myelodysplastic syndrome treated with azacitidine |
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| Authors: | Dae-Young Kim Je-Hwan Lee Jung-Hee Lee Kyoo-Hyung Lee Yoe-Kyeoung Kim Jae Sook Ahn Hyeoung-Joon Kim Inho Kim Sung-Soo Yoon Seonyang Park Sung Hwa Bae Soo-Mee Bang Hong Ghi Lee Ho-Jin Shin Jae Hoon Lee Yoo Hong Min Jong-Ho Won Yeung-Chul Mun Doyeun Oh |
| Institution: | 1. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea 2. Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Gwangju, Korea 3. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea 4. Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University College of Medicine, Gyeongsan, South Korea 5. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeongi-do, 463-707, South Korea 6. Department of Internal Medicine, Konkuk University Medical Center, Konkuk University College of Medicine, Seoul, South Korea 7. Department of Internal Medicine, Pusan National University Hospital, Pusan National University College of Medicine, Pusan, South Korea 8. Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, South Korea 9. Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea 10. Department of Internal Medicine, Soon Chun Hyang University Hospital, Soon Chun Hyang University College of Medicine, Seoul, South Korea 11. Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, South Korea 12. Department of Internal Medicine, Bundang CHA Hospital, Pochon CHA University College of Medicine, Seongnam, South Korea |
| Abstract: | This study was performed to identify whether cytogenetics, International Prognostic Scoring System (IPSS), or World Health Organization Classification-Based Prognostic Scoring System are predictive of the efficacy of azacitidine in patients with myelodysplastic syndrome (MDS). We retrospectively reviewed the clinical records of 113 patients with MDS treated with azacitidine. The “response alternating disease natural history,” “cytogenetic response,” and “hematologic improvement” were assessed by serial bone marrow biopsy, cytogenetic study, and hemogram analyses. The complete and partial remission rates were 17.6% and 3.9% in 51 evaluable patients. There were no significant differences in response rate in the different cytogenetic/IPSS/WPSS groups. The overall hematologic response (HR) rate was 49.6%, and the HR rate was significantly greater in patients classed as “very high” risk according to the WPSS compared with other patient groups. The 1-year overall survival (OS) rate was higher among patients with HR compared with those without HR (80.9% vs 63.3%, p?=?0.046), and the 1-year OS rate among patients classed as being at high risk by each criteria was similar to that of patients classed as being at low risk. The hazard ratio of death among patients with HR compared with those without HR was 0.17 (95% CI 0.04–0.69) for high?+?very high risk group based on WPSS. Patients in the WPSS high-risk group had an increased HR rate compared with other patient groups, and the achievement of HR was associated with a significant increase in OS. Azacitidine showed similar efficacy in all patient groups, even in patients with poor cytogenetics and in high-risk groups. |
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