Response to hypomethylating agents improves long-term outcomes for lower-risk patients with myelodysplastic syndrome in case-matched cohorts View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-12

AUTHORS

Dong Won Baek, Yoo Jin Lee, Hyunjeong Kim, Seo Yeon Ahn, Jae Sook Ahn, Ho Jin Shin, Won Sik Lee, Sang Min Lee, Ik Chan Song, Ho Sup Lee, Sung Woo Park, Yunsuk Choi, Yoon Young Cho, Sung Hwa Bae, Hyeoung Joon Kim, Sang Kyun Sohn, Joon Ho Moon

ABSTRACT

Predictive factors for initiating hypomethylating agents' (HMAs) treatment and the survival benefit of HMAs for lower-risk myelodysplastic syndrome (LR-MDS) are still unknown. This study evaluated the factors affecting the use of HMAs and compared long-term outcomes between best supportive care (BSC) and HMA groups after matching baseline clinical factors. Data of 353 patients diagnosed with LR-MDS by International Prognostic Scoring System between October 1992 and July 2013 were retrospectively analyzed. HMAs were administered continuously until a clinical response or progression. HMAs were administered to 243 patients with median 45 days (range 0-7078 days) after diagnosis, while 110 patients were treated with BSC. HMAs were administered over a median of 5 cycles and overall response was achieved in 104 patients (42.8%). The cumulative incidence of HMA treatment increased in higher-risk groups by other risk scoring systems. Three-year overall survival (OS) rate was higher in BSC group (69.1%) than HMA responders (47.4%, p = 0.065) or HMA non-responders (46.3%, p = 0.005). Among 162 case-matched cohorts, 3-year OS rates were comparable between the BSC group (67.1%) and HMA responders (58.1%, p = 0.914), while that of HMA non-responder was low (32.2%, p < 0.001). In the case-matched cohorts, HMA non-responder were associated with inferior OS rate in the multivariate analysis (hazard ratio 3.01, p = 0.001). Higher-risk groups by other clinical risk scoring systems among IPSS lower-risk patients showed an increased incidence of using HMAs. The OS rate of HMA responders among case-matched cohorts showed an improved OS rate similar to the BSC group. More... »

PAGES

2309-2317

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00277-018-3458-7

DOI

http://dx.doi.org/10.1007/s00277-018-3458-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105949241

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30073392


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