Results of treatment with azacitidine in patients aged ≥ 75 years included in the Spanish Registry of Myelodysplastic Syndromes

Blanca Xicoy, María José Jiménez, Olga García, Joan Bargay, Violeta Martínez-Robles, Salut Brunet, María Jesús Arilla, Jaime Pérez De Oteyza, Rafael Andreu, Francisco Javier Casaño, Carlos Javier Cervero, Alicia Bailén, María Díez, Bernardo González, Ana Isabel Vicente, Carme Pedro, Teresa Bernal, Elisa Luño, María Teresa Cedena, Luis PalomeraAdriana Simiele, José Manuel Calvo, Víctor Marco, Eduardo Gómez, Marta Gómez, David Gallardo, Juan Muñoz, Raquel De Paz, Javier Grau, Josep Maria Ribera, Luis Enrique Benlloch, Guillermo Sanz

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12 Citations (Scopus)

Abstract

The tolerability of azacitidine (AZA) allows its administration in elderly patients. The objective of this study was to analyze the clinical and biological characteristics, transfusion independence (TI), overall survival (OS) and toxicity in a series of 107 patients ≥ 75 years of age from the Spanish Registry of Myelodysplastic Syndromes (MDS) treated with AZA. The median age (range) was 78 (75-90) years. According to the World Health Organization (WHO) classification, 86/102 (84%) had MDS, 10/102 (10%) had mixed myeloproferative/myelodysplastic disorder and 6/102 (6%) had acute myeloblastic leukemia. Regarding MDS by the International Prognostic Scoring System on initiation of AZA, 38/84 (45%) were low-intermediate-1 risk and 46/84 (55%) were intermediate-2-high risk. Ninety-five patients (89%) were red blood cell or platelet transfusion dependent. The AZA schedule was 5-0-0 in 39/106 (37%) patients, 5-2-2 in 36/106 (34%) patients and 7 consecutive days in 31/106 (29%) patients. The median number of cycles administered was 8 (range, 1-30). Thirty-eight out of 94 (40%) patients achieved TI. Median OS (95% confidence interval [CI]) was significantly better in patients achieving TI (n = 38) compared to patients who did not (n = 56) (22 [20.1-23.9] months vs. 11.1 [4.8-17.5] months, p = 0.001). No significant differences were observed in TI rate and OS among the three different schedules. With a median follow-up of 14 (min-max, 1-50) months, the median OS (95% CI) of the 107 patients was 18 (12-23) months and the probability of OS (95% CI) at 2 years was 34% (22-46%). Cycles were delayed in 31/106 (29%) patients and 47/101 patients (47%) were hospitalized for infection. These results show that treatment with AZA was feasible and effective in this elderly population, with 40% achieving TI, having a better OS than patients not achieving it. The schedule of AZA administration did not affect efficacy and toxicity. © 2014 Informa UK, Ltd.
Original languageEnglish
Pages (from-to)1300-1303
JournalLeukemia and Lymphoma
Volume55
Issue number6
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Azacitidine
  • Elderly
  • Myelodysplastic syndromes
  • Response
  • Safety

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