Hematological Improvement is a Favorable Response to Azacitidine in Patients with Acute Myeloid Leukemias and Myelodysplastic Syndromes

Aim. To evaluate types of response to azacitidine associated with improvement of overall survival (OS) rates of patients with acute myeloid leukemias (AML) and myelodysplastic syndromes (MDS).

Methods. A retrospective analyses of medical records of 14 AML patients and 13 MDS patients at the age of 39 to 84 treated with azacitidine at a dose of 75 mg/m² subcutaneously for 7 subsequent days every 28 days was performed. The therapy effectiveness was evaluated according to modified 2006 IWG criteria. The OS was calculated beginning with the date of initiation of the azacitidine therapy.

Results. From 2 to 25 azacitidine cycles was performed. Complete remission (CR) was achieved in 6 patients (22.2 %) including 4 AML and 2 MDS patients. Bone marrow remission (mCR) was diagnosed in 1 MDS patient (3.7 %). Hematological improvement was obtained in 11 patients (40.7 %) including 5 AML and 6 MDS patients. The overall response was 66.7 % (18 to 27 patients). There was no correlation between the therapy effectiveness and patients’ age, disease type, duration of the previous period, baseline hemoglobin, leukocytes, and platelets levels, and dependence on transfusions of erythrocyte suspension and thromboconcentrate. The therapy was considered ineffective in 9 patients (33.3 %). Stabilization with retained requirements of blood component transfusion was observed in 4 AML and 3 MDS patients. 2 patients presented gradual increase of the blast cell count in the bone marrow. The follow-up period was 2–29 months. The median OS of all patients was 11.5 months. The median OS of patients with CR, mCR and hematological improvement was significantly greater than that in the group of patients with stable disease and progression: 15.9 versus 7.4 months, respectively (p = 0,010).

Conclusion. Reduction of transfusion requirement and/or stable improvement of peripheral blood levels due to azacitidine administration are associated with improved OS rates of AML and MDS patients.

• Ivan Ivanovich Kostroma Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024 ; ФГБУ «Российский научно-исследовательский институт гематологии и трансфузиологии» ФМБА РФ, 2-я Советская ул., д. 16, Санкт-Петербург, Российская Федерация, 191024
• S.V. Gritsaev Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024 ; ФГБУ «Российский научно-исследовательский институт гематологии и трансфузиологии» ФМБА РФ, 2-я Советская ул., д. 16, Санкт-Петербург, Российская Федерация, 191024
• E.V. Karyagina Municipal Hospital No. 15, 4 Avangardnaya str., Saint Petersburg, Russian Federation, 198205 ; ГБУЗ «Городская больница № 15», ул. Авангардная, д. 4, Санкт-Петербург, Российская Федерация,198205
• A.S. Nizamutdinova Alexandrovskaya Municipal Hospital No. 17, 4 pr-t Solidarnosti, Saint Petersburg, Russian Federation, 193312 ; Александровская городская больница № 17, пр-т Солидарности, д. 4, Санкт-Петербург, Российская Федерация, 193312
• I.S. Martynkevich Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024 ; ФГБУ «Российский научно-исследовательский институт гематологии и трансфузиологии» ФМБА РФ, 2-я Советская ул., д. 16, Санкт-Петербург, Российская Федерация, 191024
• K.M. Abdulkadyrov Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024 ; ФГБУ «Российский научно-исследовательский институт гематологии и трансфузиологии» ФМБА РФ, 2-я Советская ул., д. 16, Санкт-Петербург, Российская Федерация, 191024

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