Differential response to hypomethylating agents based on sex: a report on behalf of the MDS Clinical Research Consortium (MDS CRC)*

Amy Dezern, Amer M. Zeidan, John Barnard, Wesley Hand, Najla Al Ali, Francis Brown, Cassie Zimmerman, Gail J. Roboz, Guillermo Garcia-Manero, David P. Steensma, Rami S. Komrokji, Mikkael A. Sekeres, behalf of the Evans MDS Clinical Research Consortium on behalf of the Evans MDS Clinical Research Consortium

Research output: Contribution to journalArticle

Abstract

First-line therapy for higher-risk myelodysplastic syndromes (MDS) includes decitabine (DAC) or azacitidine (AZA). Variables have not identified differential response rates between these. We assessed the influence of patient sex on outcomes including overall survival (OS) in 642 patients with higher-risk MDS treated with AZA or DAC. DAC-treated patients (35% of females, 31% of males) had marginally better OS than AZA-treated patients (p = .043), (median OS of 18.7 months versus 16.4 months), but the difference varied strongly by sex. Female patients treated with DAC had a longer median OS (21.1 months, 95% CI: 16.0–28.0) than female patients treated with AZA (13.2 months, 95% CI: 11.0–15.9; p = .0014), while for males there was no significant difference between HMAs (median OS 18.3 months with DAC versus 17.9 months for AZA, p = .59). The biological reason for this variability is unclear, but may be a consequence of differences in cytidine deaminase activity between men and women.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Oct 24 2016

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Keywords

  • azacitidine
  • decitabine
  • hypomethylating agents
  • MDS
  • Sex

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Dezern, A., Zeidan, A. M., Barnard, J., Hand, W., Al Ali, N., Brown, F., Zimmerman, C., Roboz, G. J., Garcia-Manero, G., Steensma, D. P., Komrokji, R. S., Sekeres, M. A., & on behalf of the Evans MDS Clinical Research Consortium, B. O. T. E. MDS. C. R. C. (Accepted/In press). Differential response to hypomethylating agents based on sex: a report on behalf of the MDS Clinical Research Consortium (MDS CRC)*. Leukemia and Lymphoma, 1-7. https://doi.org/10.1080/10428194.2016.1246726