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Rapid loss of response after withdrawal of treatment with azacitidine: a case series in patients with higher‐risk myelodysplastic syndromes or chronic myelomonocytic leukemia |
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| Authors: | Maria Teresa Voso Massimo Breccia Monia Lunghi Antonella Poloni Pasquale Niscola Carlo Finelli Alessia Bari Pellegrino Musto Renato Zambello Luana Fianchi Giuliana Alimena Giuseppe Leone |
| Institution: | 1. Department of Hematology, Universita' Cattolica S. Cuore, , Rome, Italy;2. Department of Hematology, Università La Sapienza, , Rome, Italy;3. Department of Hematology, Università del Piemonte Orientale Amedeo Avogadro, , Novara, Italy;4. Department of Hematology, Università Politecnica delle Marche, , Ancona, Italy;5. Department of Hematology, Ospedale S. Eugenio, , Roma, Italy;6. Department of Hematology, Universita' di Bologna, , Bologna, Italy;7. Department of Hematology, Universita' di Modena and Reggio Emilia, , Modena, Italy;8. Unità di Ematologia e Trapianto di Cellule Staminali, IRCCS, Centro di Riferimento Oncologico della Basilicata, , Rionero in Vulture, Italy;9. Department of Clinical and Experimental Medicine, University of Padova, , Padova, Italy |
| Abstract: | In patients with myelodysplastic syndromes (MDS), the likelihood of having a sustained response to azacitidine is increased by maximizing treatment duration. This is important as prognosis postrelapse is poor. There is also the concern that early termination of treatment may result in rapid disease progression. We reviewed outcomes in 13 patients who discontinued azacitidine (decitabine in one patient) while still responding to the treatment. Most patients rapidly relapsed; median time to progression was 5.4 months. Reasons for treatment discontinuation included comorbidities, infections, and patient choice. These findings illustrate the risk of prematurely terminating azacitidine therapy in MDS. |
| Keywords: | myelodysplastic syndromes chronic myelomonocytic leukemia hypomethylating agents azacitidine |