Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries

María Díez-Campelo, Jose I. Lorenzo, Raphael Itzykson, Silvia M. Rojas, Céline Berthon, Elisa Luño, Odile Beyne-Rauzy, Jaime Perez-Oteyza, Norbert Vey, Joan Bargay, Sophie Park, Teresa Cedena, Dominique Bordessoule, Juan A. Muñoz, Emmanuel Gyan, Esperanza Such, Sorin Visanica, Félix López-Cadenas, Stéphane de Botton, Jesús M. Hernández-RivasShanti Ame, Aspasia Stamatoullas, Jacques Delaunay, Celia Salanoubat, Françoise Isnard, Romain Guieze, Joan Pérez Guallar, Llorenc Badiella, Guillermo Sanz, Consuelo Cañizo, Pierre Fenaux

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    © 2018 John Wiley & Sons Ltd Treatment with azacitidine (AZA) has been suggested to be of benefit for higher-risk myelodysplastic syndrome (HR-MDS) patients with chromosome 7 abnormalities (Abn 7). This retrospective study of 235 HR-MDS patients with Abn 7 treated with AZA (n = 115) versus best supportive care (BSC; n = 120), assessed AZA treatment as a time-varying variable in multivariable analysis. A Cox Regression model with time-interaction terms of overall survival (OS) at different time points confirmed that, while chromosome 7 cytogenetic categories (complex karyotype [CK] versus non-CK) and International Prognostic Scoring System risk (high versus intermediate-2) retained poor prognosis over time, AZA treatment had a favourable impact on OS during the first 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P < 0·001 at 1 year, 0·7 P = 0·019 at 2 years; 0·73 P = 0·029 at 3 years). This benefit was present in all chromosome 7 categories, but tended to be greater in patients with CK (risk reduction of 82%, 68% and 53% at 1, 3 and 6 months in CK patients; 79% at 1 month in non-CK patients, P < 0·05 for all). AZA also significantly improved progression-free survival (P < 0·01). This study confirms a time-dependent benefit of AZA on outcome in patients with HR-MDS and cytogenetic abnormalities involving chromosome 7, especially for those with CK.
    Original languageEnglish
    Pages (from-to)350-359
    JournalBritish Journal of Haematology
    Issue number3
    Publication statusPublished - 1 May 2018


    • azacitidine
    • chromosome 7 abnormalities
    • high risk MDS
    • time-dependent analysis


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