Predictive factors of response and survival in myelodysplastic syndrome treated with erythropoietin and G-CSF: the GFM experience
| Autor: | Marie-Thérèse Daniel, Keith Bourgeois, Lionel Mannone, Valérie Bardet, L. Aljassem, Stéphane Cheze, Beatrice Mahe, Charikleia Kelaidi, Lionel Ades, Sophie Park, Geneviève Leroux, Norbert Vey, Martine Escoffre-Barbe, Odile Beyne-Rauzy, Pascale Lepelley, Christophe Ravoet, Augustin Ferrant, Peter L. Greenberg, Hervé Dombret, François Dreyfus, Pierre Fenaux, Sophie Grabar, Aspasia Stamatoullas, Valérie Coiteux, Françoise Picard |
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| Rok vydání: | 2007 |
| Předmět: |
Oncology
Male medicine.medical_specialty Time Factors Immunology Biochemistry Disease-Free Survival Cohort Studies Predictive Value of Tests Internal medicine Granulocyte Colony-Stimulating Factor medicine Humans Survival rate Erythropoietin Aged Epoetin beta Hematology business.industry Cell Biology Granulocyte colony-stimulating factor Survival Rate International Prognostic Scoring System Myelodysplastic Syndromes Cohort Female business Blast Crisis Erythrocyte Transfusion Cohort study medicine.drug |
| Zdroj: | Blood. 111(2) |
| ISSN: | 0006-4971 |
| Popis: | We analyzed prognostic factors of response, response duration, and possible impact on survival of epoetin α, epoetin β, or darbepoetin α (DAR) with or without granulocyte colony-stimulating factor in 403 myelodysplastic syndrome (MDS) patients. Sixty-two percent (40% major and 22% minor) and 50% erythroid responses were seen, and median response duration was 20 and 24 months according to IWG 2000 and 2006 criteria, respectively. Significantly higher response rates were observed with less than 10% blasts, low and int-1 International Prognostic Scoring System (IPSS), red blood cell transfusion independence, serum EPO level less than 200 IU/L, and, with IWG 2006 criteria only, shorter interval between diagnosis and treatment. Significantly longer response duration was associated with major response (IWG 2000 criteria), IPSS low to INT-1, blasts less than 5%, and absence of multilineage dysplasia. Minor responses according to IWG 2000 were reclassified as “nonresponders” or “responders” according to IWG 2006 criteria. However, among those IWG 2000 minor responders, response duration did not differ between IWG 2006 responders and nonresponders. Multivariate adjusted comparisons of survival between our cohort and the untreated MDS cohort used to design IPSS showed similar rate of progression to acute myeloid leukemia in both cohorts, but significantly better overall survival in our cohort, suggesting that epoetin or DAR treatment may have a favorable survival impact in MDS. |
| Databáze: | OpenAIRE |
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