Abstract:
BACKGROUND:Azacitidine (AZA) is the standard of care for higher-risk myelodysplastic syndrome (HR-MDS) patients ineligible for intensive therapy. Clinical outcome discrepancies reported in clinical trials and real-life settings stimulate the search for new prognostic factors. METHODS:We retrospectively evaluated 315 MDS, 20-30% blast acute myeloid leukemia (AML) and chronic myelomonocytic leukemia (CMML) patients treated with azacitidine in 12 centers cooperating within the Polish Adult Leukemia Group (PALG). RESULTS:The median number of AZA cycles was 7 (1-69) and 24% patients received fewer than 4 cycles (early failure, EF). Serum albumin level was an independent predictor of EF occurrence. Complete remission (CR) was obtained in 20% and partial remission (PR) in 12% of patients. Hematologic improvement - erythroid (HI-E), neutrophil (HI-N), or platelet (HI-P) was achieved in 51%, 36%, and 48% of patients, respectively. No factors significantly predicted CR or PR in the multivariate analysis. For HI-E and HI-P, lower LDH level predicted response. Median survival was 15 (13-19) months. Lower serum albumin level, serious infection and receiving <4 AZA cycles independently predicted a worse overall survival (OS) (p < 0.05). CONCLUSION:Serum albumin assessment before azacitidine treatment can help to identify patients with higher risk of early failure and worse clinical outcome.
journal_name
Hematologyjournal_title
Hematology (Amsterdam, Netherlands)authors
Mądry K,Lis K,Tukiendorf A,Szwedyk P,Kapelko-Słowik K,Subocz E,Gołos A,Makowska W,Masternak A,Kopińska A,Czemerska M,Zawadzka-Leska S,Rusicka P,Drozd-Sokołowska J,Wiater E,Hołojda J,Pogłódek B,Centkowski P,Waszczuk-Gadoi
10.1080/16078454.2021.1956182keywords:
["Myelodysplastic syndromes","albumin","azacitidine"]subject
Has Abstractpub_date
2021-12-01 00:00:00pages
556-564issue
1eissn
1024-5332issn
1607-8454journal_volume
26pub_type
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