Prolonged survival with improved tolerability in higher-risk myelodysplastic syndromes: Azacitidine compared with low dose ara-C: Research paper

Pierre Fenaux, Norbert Gattermann, John F. Seymour, Eva Hellström-Lindberg, Ghulam J. Mufti, Ulrich Duehrsen, Steven D. Gore, Fernando Ramos, Odile Beyne-Rauzy, Alan List, David McKenzie, Jay Backstrom, Charles L. Beach

Research output: Contribution to journalArticlepeer-review

Abstract

In the phase III AZA-001 trial, low-dose cytarabine (LDara-C), the most widely used low-dose chemotherapy in patients with higher-risk myelodysplastic syndrome (MDS) who are ineligible for intensive treatment, was found to be associated with poorer survival compared with azacitidine. This analysis further compared the efficacy and the toxicity of these two drug regimens. Before randomization, investigators preselected patients to receive a conventional care regimen, one of which was LDara-C. Of 94 patients preselected to LDara-C, 45 were randomized to azacitidine and 49 to LDara-C. Azacitidine patients had significantly more and longer haematologicalal responses and increased red blood cell transfusion independence. Azacitidine prolonged overall survival versus LDara-C in patients with poor cytogenetic risk, presence of -7/del(7q), and French-American-British subtypes refractory anaemia with excess blasts (RAEB) and RAEB in transformation. When analyzed per patient year of drug exposure, azacitidine treatment was associated with fewer grade 3-4 cytopenias and shorter hospitalisation time than LDara-C in these higher-risk MDS patients.

Original languageEnglish (US)
Pages (from-to)244-249
Number of pages6
JournalBritish journal of haematology
Volume149
Issue number2
DOIs
StatePublished - Apr 2010

Keywords

  • Azacitidine
  • Higher-risk myelodysplastic syndromes
  • Low-dose cytarabine (ara-C)
  • Myelodysplastic syndromes
  • Survival

ASJC Scopus subject areas

  • Hematology

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