Abstract:
:Hypomethylating agents (HMAs) improve survival in patients with higher-risk myelodysplastic syndromes (MDS) but are less well-studied in lower-risk disease. We compared the safety and efficacy of low-dose decitabine vs low-dose azacitidine in this group of patients. Adults with low- or intermediate 1-risk MDS or MDS/myeloproliferative neoplasm (MPN), including chronic myelomonocytic leukemia, according to the International Prognostic Scoring System, were randomly assigned using a Bayesian adaptive design to receive either azacitidine 75 mg/m2 intravenously/subcutaneously daily or decitabine 20 mg/m2 intravenously daily for 3 consecutive days on a 28-day cycle. The primary outcome was overall response rate (ORR). Between November 2012 and February 2016, 113 patients were treated: 40 (35%) with azacitidine and 73 (65%) with decitabine. The median age was 70 years; 81% of patients were intermediate 1-risk patients. The median number of cycles received was 9. The ORRs were 70% and 49% (P = .03) for patients treated with decitabine and azacitidine, respectively. Thirty-two percent of patients treated with decitabine became transfusion independent compared with 16% of patients treated with azacitidine (P = .2). Cytogenetic response rates were 61% and 25% (P = .02), respectively. With a median follow-up of 20 months, the overall median event-free survival was 18 months: 20 and 13 months for patients treated with decitabine and azacitidine, respectively (P = .1). Treatment was well tolerated, with a 6-week mortality rate of 0%. The use of low-dose HMAs is safe and effective in patients with lower-risk MDS and MDS/MPN. Their effect on the natural history of lower-risk disease needs to be further studied. This trial was registered at clinicaltrials.gov (identifier NCT01720225).
journal_name
Bloodjournal_title
Bloodauthors
Jabbour E,Short NJ,Montalban-Bravo G,Huang X,Bueso-Ramos C,Qiao W,Yang H,Zhao C,Kadia T,Borthakur G,Pemmaraju N,Sasaki K,Estrov Z,Cortes J,Ravandi F,Alvarado Y,Komrokji R,Sekeres MA,Steensma DP,DeZern A,Roboz G,doi
10.1182/blood-2017-06-788497subject
Has Abstractpub_date
2017-09-28 00:00:00pages
1514-1522issue
13eissn
0006-4971issn
1528-0020pii
blood-2017-06-788497journal_volume
130pub_type
杂志文章,随机对照试验相关文献
BLOOD文献大全abstract::The content of filamentous actin in individual platelets was measured by flow cytometry, using a fluorescent probe specific for filamentous actin (F-actin), 7-nitrobenz-2-oxa-1,3-phallacidin (NBD-phallacidin). NBD-phallacidin binding to fixed platelets was specific in that either pretreatment of platelets with unlabel...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1992-02-15 00:00:00
abstract::The choice of either induction or postremission therapy for adults with acute myeloid leukemia is still largely based on the "one size fits all" principle. Moreover, pretreatment prognostic parameters, especially chromosome and gene abnormalities, may fail in predicting individual patient outcome. Measurement of minim...
journal_title:Blood
pub_type: 杂志文章,评审
doi:10.1182/blood-2011-08-363291
更新日期:2012-01-12 00:00:00
abstract::Recent studies of retroviral-mediated gene transfer have shown that retroviral integrations themselves may trigger nonmalignant clonal expansion of hematopoietic stem cells (HSCs) in transplant recipients. These observations suggested that previous conclusions of HSC dynamics based on gamma-retroviral gene marking sho...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2008-03-142661
更新日期:2008-10-15 00:00:00
abstract::To investigate whether the migratory ability of peripheral blood-derived CD34+ cells of patients undergoing autologous peripheral blood stem cell transplantation is related to the homing efficiency of these cells, the migration in vitro of these cells was determined and correlated with in vivo hematopoietic recovery. ...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood.v97.3.799
更新日期:2001-02-01 00:00:00
abstract::Signaling through the Notch pathway plays an essential role in inducing T-lineage commitment and promoting the maturation of immature thymocytes. Using an in vitro culture system, we show that 2 different classes of Notch ligands, Jagged1 or Delta1, transmit distinct signals to T-cell progenitors. OP9 stromal cells ex...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2004-08-3257
更新日期:2005-02-15 00:00:00
abstract::Crystallographic structures indicate that gamma-chain residue Asn308 participates in D:D interactions and indeed substitutions of gammaAsn308 with lysine or isoleucine have been identified in dysfibrinogens with impaired polymerization. To probe the role of Asn308 in polymerization, we synthesized 3 variant fibrinogen...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2003-12-4296
更新日期:2004-06-01 00:00:00
abstract::To determine the clonal nature of hematopoiesis and to assess lineage involvement in patients with myelodysplastic syndromes (MDS), we used restriction fragment length polymorphisms of the X-linked genes phosphoglycerate kinase (PGK1) and hypoxanthine phosphoribosyltransferase (HPRT) and the X-linked probe M27 beta. E...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::The transcription of insulin-like growth factor 2 (IGF-2) is affected by genomic imprinting, a multistep process through which the parental origin of a gene influences its transcription. The maternal copy of IGF-2 is silenced in most human tissues, but in the choroid plexus and the adult liver both alleles of IGF-2 ar...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract::The membrane-anchored CX3C chemokine fractalkine (FKN) is expressed on activated endothelium and is associated with the development of atherosclerosis. The potential of FKN in mediating platelet adhesion beyond platelet activation remains unexplored to date. A flow-based adhesion assay was used to study the adhesion o...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2011-02-335471
更新日期:2011-05-05 00:00:00
abstract::In this issue of Blood, Poli et al demonstrate that heparin analogs engineered to minimize their anticoagulant properties can potently downregulate hepcidin production in vitro and in vivo, and may potentially be used to treat the anemia of inflammation. ...
journal_title:Blood
pub_type: 评论,杂志文章
doi:10.1182/blood-2014-01-549519
更新日期:2014-03-06 00:00:00
abstract::Perforin (pfp) and interferon-gamma (IFN-gamma) together in C57BL/6 (B6) and BALB/c mouse strains provided optimal protection in 3 separate tumor models controlled by innate immunity. Using experimental (B6, RM-1 prostate carcinoma) and spontaneous (BALB/c, DA3 mammary carcinoma) models of metastatic cancer, mice defi...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood.v97.1.192
更新日期:2001-01-01 00:00:00
abstract::Immune thrombocytopenia (ITP) is an acquired bleeding disorder characterized by antibody-mediated platelet destruction. Different mechanisms have been suggested to explain accelerated platelet clearance and impaired thrombopoiesis, but the pathophysiology of ITP has yet to be fully delineated. In this study, we tested...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood.2019003770
更新日期:2020-06-18 00:00:00
abstract::Liver X receptors (LXRs) are transcription factors involved in the regulation of cholesterol homeostasis. LXR ligands have athero-protective properties independent of their effects on cholesterol metabolism. Platelets are involved in the initiation of atherosclerosis and despite being anucleate express nuclear recepto...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2010-09-306142
更新日期:2011-05-26 00:00:00
abstract::In the present study we used multiparameter flow cytometry and cell sorting to evaluate fetal bone marrow, a rich source of cells early in lymphoid development. We found CD7 to be expressed on a subset of CD19+ cells, including some that had matured to cytoplasmic mu+ (pre-B) and surface mu+ (B) cells. In addition, a ...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Recent studies have shown a discrepancy between the level of tissue factor (TF) expression and the level of TF procoagulant activity on the apical and basolateral surface domains of polarized epithelial cells. The present investigation was performed to elucidate possible reasons for the discordant expression of TF and...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::An association between platelets, angiogenesis, and cancer has long been recognized, but the mechanisms linking them remains unclear. Platelets regulate new blood vessel growth through numerous stimulators and inhibitors of angiogenesis by several pathways, including differential exocytosis of angiogenesis regulators....
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2011-02-334524
更新日期:2011-08-04 00:00:00
abstract::The efficacy of the addition of intensive therapy with daunorubicin (45 mg/m2 IV on days 1, 2, 3) to an otherwise identical induction program consisting of vincristine, prednisone, and L-asparaginase was assessed in 177 previously untreated adults (greater than or equal to 20 years of age) with acute lymphocytic leuke...
journal_title:Blood
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-07-01 00:00:00
abstract::Acute myeloid leukemia (AML) cases with 11q23 abnormalities involving the MLL gene comprise one category of recurring genetic abnormalities in the WHO classification. In an unselected series of 1897 AML cases, 54 patients with an 11q23/MLL rearrangement were identified, resulting in an incidence of 2.8%. The incidence...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2003-02-0434
更新日期:2003-10-01 00:00:00
abstract::Identification of receptor activator of nuclear factor-kappaB (RANK) and RANK-ligand (RANKL) has provided new insights into the osteoclast differentiation pathway. Osteoclast precursor cells were isolated using monoclonal antibodies against c-Fms and RANK, and the effect of adherence on the in vitro differentiation an...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:2000-12-15 00:00:00
abstract::Reversible interactions of glycoconjugates on leukocytes with P- and E-selectin on endothelial cells mediate tethering and rolling of leukocytes in inflamed vascular beds, the first step in their recruitment to sites of injury. Although selectin ligands on hematopoietic precursors have been identified, here we review ...
journal_title:Blood
pub_type: 杂志文章,评审
doi:10.1182/blood-2011-07-343566
更新日期:2011-12-22 00:00:00
abstract::The continuous generation of mature blood cells from primitive multipotent progenitor cells requires a highly complex series of cellular events that are still largely unknown. To examine the molecular events associated with the commitment of these hematopoietic progenitor cells to the megakaryocytic lineage, the alpha...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1997-10-15 00:00:00
abstract::Folylpolyglutamate synthetase (FPGS) is responsible for the metabolism of natural folates and a broad range of folate antagonists to polyglutamate derivatives. Recent studies indicated increased accumulation of methotrexate (MTX) polyglutamates (MTX-PG) in blast cells as a predictor of favorable treatment outcome in c...
journal_title:Blood
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-07-15 00:00:00
abstract::Serum cytokines and chemokines may reflect tumor biology and host response in follicular lymphoma (FL). To determine whether the addition of these biological factors may further refine prognostication, 30 cytokines and chemokines were measured in pretreatment serum specimens from newly diagnosed FL patients (n = 209) ...
journal_title:Blood
pub_type: 杂志文章,meta分析
doi:10.1182/blood-2014-06-583369
更新日期:2015-02-05 00:00:00
abstract::The ataxia telangiectasia mutated (ATM)-interacting protein ATMIN mediates noncanonical ATM signaling in response to oxidative and replicative stress conditions. Like ATM, ATMIN can function as a tumor suppressor in the hematopoietic system: deletion of Atmin under the control of CD19-Cre results in B-cell lymphomas i...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2015-09-672980
更新日期:2016-10-20 00:00:00
abstract::Mast cells are inflammatory and immunoregulatory cells resident in tissues. They develop from bone marrow-derived progenitor cells that enter the tissue through the blood circulation. The specific localization and migration of mast cells in tissues is dependent on their interaction with extracellular matrix (ECM) prot...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood.v99.3.966
更新日期:2002-02-01 00:00:00
abstract::Chronic infection with Schistosoma mansoni induces in humans and mice a Th2-dominant immune response in which eosinophils and IgE are conspicuously elevated. Human eosinophils express IgE receptors that participate in an IgE-dependent eosinophil-mediated ADCC reaction against Schistosomula larvae in vitro. To investig...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1997-05-15 00:00:00
abstract::Loss or mutation of the TP53 tumor suppressor gene is not commonly observed in acute myeloid leukemia (AML), suggesting that there is an alternate route for cell transformation. We investigated the hypothesis that previously observed Bcl-2 family member overexpression suppresses wild-type p53 activity in AML. We demon...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2006-02-004234
更新日期:2007-03-15 00:00:00
abstract::Clonal chromosomal abnormalities in Philadelphia chromosome-negative (CCA/Ph-) metaphases emerge as patients with chronic phase chronic myeloid leukemia (CP-CML) are treated with tyrosine kinase inhibitors (TKIs). We assessed the characteristics and prognostic impact of 598 patients with CP-CML treated on clinical tri...
journal_title:Blood
pub_type: 临床试验,杂志文章
doi:10.1182/blood-2017-07-792143
更新日期:2017-11-09 00:00:00
abstract::The bone marrow (BM) microenvironment consists of extracellular-matrix and the cellular compartment including immune cells. Multiple myeloma (MM) cell and BM accessory cell interaction promotes MM survival via both cell-cell contact and cytokines. Immunomodulatory agents (IMiDs) target not only MM cells, but also MM c...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2010-04-279893
更新日期:2010-10-28 00:00:00
abstract::Fanconi anemia (FA) is an autosomal recessive disease marked by developmental defects, bone marrow failure, and cancer susceptibility. FA cells are hypersensitive to DNA cross-linking and alkylating agents and accumulate in the G2 phase of the cell cycle in response to these agents. FA cells also display genomic insta...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1996-08-01 00:00:00