Abstract：
:Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2 per day on Days 1-5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4-57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
journal_name
Leukemiajournal_title
Leukemiaauthors
Santini V,Allione B,Zini G,Gioia D,Lunghi M,Poloni A,Cilloni D,Sanna A,Masiera E,Ceccarelli M,Abdel-Wahab O,Terenzi A,Angelucci E,Finelli C,Onida F,Pelizzari A,Ferrero D,Saglio G,Figueroa M,Levis Adoi
10.1038/leu.2017.186subject
Has Abstractpub_date
2018-02-01 00:00:00pages
413-418issue
2eissn
0887-6924issn
1476-5551pii
leu2017186journal_volume
32pub_type
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