Prolonged survival with improved tolerability in higher‐risk myelodysplastic syndromes: azacitidine compared with low dose ara‐C
Open Access
- 22 March 2010
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 149 (2), 244-249
- https://doi.org/10.1111/j.1365-2141.2010.08082.x
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.Keywords
This publication has 23 references indexed in Scilit:
- Arsenic trioxide and low‐dose cytarabine in older patients with untreated acute myeloid leukemia, excluding acute promyelocytic leukemiaCancer, 2008
- Combined DNA Methyltransferase and Histone Deacetylase Inhibition in the Treatment of Myeloid NeoplasmsCancer Research, 2006
- Low-dose cytosine arabinoside (LD-AraC) vs LD-AraC plus granulocyte/macrophage colony stimulating factor vs LD-AraC plus Interleukin-3 for myelodysplastic syndrome patients with a high risk of developing acute leukemia: final results of a randomized phase III study (06903) of the EORTC Leukemia Cooperative GroupLeukemia, 2005
- Low Dose Ara-C for Myelodysplastic Syndromes: is it Still a Current Therapy?Leukemia & Lymphoma, 2004
- All Trans Retinoic Acid with Low Dose Cytosine Arabinoside in the Treatment of Myelodysplastic SyndromeLeukemia & Lymphoma, 1998
- Is there still a role for low-dose cytosine arabinoside in de novo acute myeloid leukemia in the elderly?Annals of Hematology, 1993
- The evaluation of low-dose cytarabine in the treatment of myelodysplastic syndromes: A phase-III intergroup studyAnnals of Hematology, 1992
- A predictive model for the clinical response to low dose ara‐C: a study of 102 patients with myelodysplastic syndromes or acute leukaemiaBritish Journal of Haematology, 1992
- Small doses of ARA-C in the treatment of acute myeloid leukaemia: differentiation of myeloid leukaemia cells?British Journal of Haematology, 1982