Chronic myelomonocytic leukemia treated with 5-azacytidine - results from the Hellenic 5-Azacytidine Registry: proposal of a new risk stratification system.

Autor: Diamantopoulos PT; a First Department of Internal Medicine, Hematology Unit , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece., Kotsianidis I; b Department of Hematology , University Hospital of Alexandroupolis , Alexandroupoli , Greece., Symeonidis A; c Department of Internal Medicine , University Hospital of Patras , Rio , Greece., Pappa V; d Haematology Division, Second Department of Internal Medicine , Attikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece., Galanopoulos A; e Department of Clinical Hematology , ' G. Gennimatas' District General Hospital , Athens , Greece., Gogos D; f Vostanio General Hospital , Mytilene , Greece., Karakatsanis S; g Third Department of Medicine , ' Sotiria' General Hospital of Thoracic Diseases, Hematology Unit, National and Kapodistrian University of Athens, Medical School , Athens , Greece., Papadaki H; h Haematology Laboratory , School of Medicine, University of Crete , Greece., Palla A; i ' St. George' General Hospital , Chania , Greece., Hatzimichael E; j Department of Haematology , University of Ioannina , Ioannina , Greece., Dimou M; k First Propedeutic Department of Internal Medicine, School of Medicine , National and Kapodistrian University of Athens , Athens , Greece., Papageorgiou S; d Haematology Division, Second Department of Internal Medicine , Attikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece., Delimpasis S; l Hematology Department , Evangelismos General Hospital , Athens , Greece., Papaioannou M; m Hematology Department , University General Hospital of Thessaloniki AHEPA , Thessaloniki , Greece., Papoutselis M; b Department of Hematology , University Hospital of Alexandroupolis , Alexandroupoli , Greece., Kourakli A; c Department of Internal Medicine , University Hospital of Patras , Rio , Greece., Tsokanas D; e Department of Clinical Hematology , ' G. Gennimatas' District General Hospital , Athens , Greece., Anagnostopoulos A; n Hematology Department , General Hospital of Thessaloniki 'George Papanikolaou' , Thessaloniki , Greece., Kontos CK; o Department of Biochemistry and Molecular Biology , National and Kapodistrian University of Athens , Athens , Greece., Panayiotidis P; k First Propedeutic Department of Internal Medicine, School of Medicine , National and Kapodistrian University of Athens , Athens , Greece., Viniou NA; a First Department of Internal Medicine, Hematology Unit , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece.
Jazyk: angličtina
Zdroj: Leukemia & lymphoma [Leuk Lymphoma] 2019 Jul; Vol. 60 (7), pp. 1721-1730. Date of Electronic Publication: 2018 Nov 14.
DOI: 10.1080/10428194.2018.1540783
Abstrakt: Hypomethylating agents are widely used in chronic myelomonocytic leukemia (CMML). We analyzed the characteristics of 88 patients with CMML homogeneously treated with 5-azacytidine (Hellenic 5-Azacytidine Registry). The overall response rate was 48.9% and the median overall survival (OS) 29.7 months. Out of the seven most widely used prognostic scoring systems for CMML, the Dusseldorf score (DUSS) showed the best prognostic capability (HR, 2.27; p  < .001). Forty-one (48.8%) patients progressed to acute myeloid leukemia (AML) after a median time of 15.2 months following treatment initiation. High serum ferritin levels at diagnosis were independently correlated with low OS (HR, 2.84; p  = .022), as were circulating blasts (HR, 3.47; p  = .014), while a platelet count <100 × 10 9 /L was marginally predictive of lower OS (HR, 1.45; p  = .06). We selected these three factors to create a new risk stratification system for CMML with three risk groups. Finally, we highlighted for the first time the prognostic significance of serum ferritin levels in CMML.
Databáze: MEDLINE
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