Clinical impacts of severe thrombocytopenia in the first cycle of azacitidine monotherapy and cytogenetics in patients with myelodysplastic syndrome: The Kyoto Conditional Survival Scoring System.

Autor: Inoue Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Okamoto H; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Miyashita A; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Kawaji-Kanayama Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Chinen S; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Fujino T; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Tsukamoto T; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Shimura Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Mizutani S; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Kaneko H; Department of Hematology, Aiseikai Yamashina Hospital, Kyoto 607-8086, Japan., Kuwahara-Ota S; Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto 603-8151, Japan., Fuchida SI; Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto 603-8151, Japan., Nishiyama D; Department of Hematology, Fukuchiyama City Hospital, Fukuchiyama, Kyoto 620-0056, Japan., Hirakawa K; Department of Hematology, Fukuchiyama City Hospital, Fukuchiyama, Kyoto 620-0056, Japan., Uchiyama H; Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan., Uoshima N; Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8031, Japan., Kawata E; Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan., Kuroda J; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Jazyk: angličtina
Zdroj: Oncology letters [Oncol Lett] 2023 Dec 18; Vol. 27 (2), pp. 62. Date of Electronic Publication: 2023 Dec 18 (Print Publication: 2024).
DOI: 10.3892/ol.2023.14193
Abstrakt: Azacitidine (AZA) has been one of the standard treatments for transplantation-ineligible patients with myelodysplastic syndrome (MDS); however, hematological toxicities frequently cause treatment interruption in the early phase of the therapy. The present study conducted a multicenter retrospective study to investigate the prognostic impacts of various factors, including factors included in the Revised International Prognostic Scoring System (IPSS-R) and severe cytopenia in the early phase of AZA monotherapy in 212 patients with MDS. Severe cytopenia was evaluated after the initiation of therapy by absolute neutrophil counts on the 29th day after AZA (ANC29) initiation, and red cell concentrates (RCC) and platelet concentrate (PC) transfusion units required within 28 days from the start of AZA, designated in the present study as RCC28 and PC28, respectively. The survival period was determined from the 29th day of AZA treatment to death from any cause as the conditional survival period after the first cycle of AZA (CS-AZA1). Multivariate analysis demonstrated that severe thrombocytopenia defined by >30 units of PC28 and very poor risk cytogenetics according to IPSS-R were independent prognostic factors for CS-AZA1. The Kyoto Conditional Survival Scoring System was subsequently developed by incorporating severe thrombocytopenia defined by PC28 and very poor risk cytogenetics, which successfully stratified the risks of the patients in CS-AZA1. In conclusion, extreme PC transfusion dependency during the first cycle of AZA and very poor risk cytogenetics are important prognostic factors in AZA monotherapy for MDS.
Competing Interests: TF has received honoraria from Takeda Pharmaceutical; TT has received honoraria from Bristol Myers Squibb (BMS), Janssen Pharmaceutical, Sanofi, Kyowa Kirin and Chugai Pharmaceutical; YS has received honoraria from Ono Pharmaceutical, BMS, Janssen Pharmaceutical, Sanofi, Kyowa Kirin, Takeda Pharmaceutical and Chugai Pharmaceutical; SM has received honoraria from Sanofi and Ono Pharmaceutical; and NU has received honoraria from BMS and Takeda. JK is a consultant for Janssen Pharmaceutical, Abbvie and BMS; has received research funding from Kyowa Kirin, Chugai Pharmaceutical, Ono Pharmaceutical, Shionogi and BMS; and has received honoraria from Janssen Pharmaceutical, Kyowa Kirin, Chugai Pharmaceutical, Ono Pharmaceutical, Sanofi and BMS. None of the pharmaceutical companies aforementioned benefited from the present research or played any role in our study. All other authors declare that they have no competing interests.
(Copyright: © Inoue et al.)
Databáze: MEDLINE
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