scholarly journals Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents

2017 ◽  
Vol 92 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Elias Jabbour ◽  
Paolo Strati ◽  
Monica Cabrero ◽  
Susan O'Brien ◽  
Farhad Ravandi ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Cytogenetic Response ◽  
Hypomethylating Agents ◽  
Complete Cytogenetic Response

Microtransplantation with Decitabine and Cytarabine Improves Patient Outcomes in Myelodysplastic Syndromes

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1709-1709
Author(s):  
Huisheng Ai ◽  
Kaixun Hu ◽  
Qiyun Sun ◽  
Xiao Li ◽  
Mei Guo ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Infection Rate ◽  
Myelodysplastic Syndromes ◽  
Early Phase ◽  
Mononuclear Cells ◽  
Conflicts Of Interest ◽  
Cytogenetic Response ◽  
The Other ◽  
Poor Overall Survival ◽  
Complete Cytogenetic Response

Abstract Abstract 1709 The outcome of myelodysplastic syndromes (MDS) still remains unsatisfactory, with a low complete remission (CR) rate and a poor overall survival rate. Decitabine improved the overall responses of MDS as a hypomethylating agent, but CR rates remain low and prolonged pancytopenia. Our recently study showed that infusion of G-CSF mobilized HLA-mismatched peripheral blood stem cells (G-PBSC) can improve the outcome of chemotherapy for acute myeloid leukemia in elderly patients. However, whether G-PBSC combining decitabine and cytarabine chemotherapy will improve outcomes in MDS patients is unknown. Material and methods: Total of 72 patients with MDS, from 16 to 82 years of age, were assigned to receive decitabine 25–30 mg/m2daily for 4 days with cytarabine 150 mg/m2 daily for 7 days by intravenous followed to infusion of G-PBSC on 24 hours after each completion of the cytarabine therapy (Microtransplantation-group, n=28) or decitabine 20 mg/m2 daily for 5days (Decitabine group, n=27) or 15 mg/m2 daily for 5days (low decitabine group, n=17). The infused cells of mononuclear cells and CD34+ cells with HLA-mismatched in 3 loci (n=22) and 2 loci (n=5) and 1 loci (n=1) were 3.33(3.04–10.8)108/kg, 2.26(0.68–5.25)106/kg and no any GVHD prophylactic treatment was used in the Microtransplantation-group. Results: Total CR rate of was 42.9%#x2610;#x0025; A14.8% and 29.4% in the three groups, respectively. That of MST-group is significantly higher than that of B group (P=0.02). The CR rate after first course in MST group is 21.5% which was higher the other two groups (10% and 0%, P=0.14#x2610;#x0025; GP=0.04). The complete cytogenetic response rate in the Microtransplantation-group was 90.9% which is highest than the other two groups (10% and 11%, P<0.001,P<0.001). The progress free survival(PFS) of Microtransplantation-group in 12 months is 50.1% which is higher than other two group (9.9%,9.6%, P=0.01#x2610;#x0025; GP=0.008). Median times of neutrophil recovering over 1×109/L in three groups after 1 course therapy was 17,19 and 13 days and median times of platelet recovering over 50×109/L was 17,26 and 28days, respectively. These of MST group recovered more fastly than those of the other groups. The severe infection rate and early phase mortality rate in three groups had no differences. No donor chimerism, no graft-versus-host disease were observed in all of the patients in the MST group. Conclusion: Our clinical results suggested that decitabine with cytarabine and microtransplantation may improve clinical response CR rate early, especially on complete cytogenetic response and PFS, no increase infection rate and early phase mortality rate. The MST may provide an new method for MDS treatment. Further studies with much more patients and long-term follow-up should be conducted. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Persistence to hypomethylating agents and clinical and economic outcomes among patients with myelodysplastic syndromes

Hematology ◽  
2021 ◽  
Vol 26 (1) ◽  
pp. 261-270
Author(s):  
Wendy Y. Cheng ◽  
Ambika Satija ◽  
Hoi Ching Cheung ◽  
Kala Hill ◽  
Tim Wert ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Economic Outcomes ◽  
Hypomethylating Agents

Effects of imatinib mesylate on normal bone marrow cells from chronic myeloid leukemia patients in complete cytogenetic response

2009 ◽  
Vol 33 (1) ◽  
pp. 170-173 ◽  
Author(s):  
Fermin M. Sanchez-Guijo ◽  
Jesus M. Hernandez ◽  
Eva Lumbreras ◽  
Patricia Morais ◽  
Carlos Santamaría ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Chronic Myeloid Leukemia ◽  
Imatinib Mesylate ◽  
Myeloid Leukemia ◽  
Bone Marrow Cells ◽  
Cytogenetic Response ◽  
Normal Bone Marrow ◽  
Normal Bone ◽  
Complete Cytogenetic Response ◽  
Marrow Cells

Prognosis of Myelodysplastic Syndromes

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 330-337 ◽  
Author(s):  
Guillermo Garcia-Manero
Keyword(s):  
Myelodysplastic Syndromes ◽  
Therapeutic Interventions ◽  
Prognostic Models ◽  
International Prognostic Scoring System ◽  
Molecular Characteristics ◽  
Hypomethylating Agents ◽  
Older Individuals ◽  
Molecular Alterations ◽  
Hematopoietic Disorders ◽  
Clinical Tools

AbstractThe myelodysplastic syndromes (MDS) are a very complex group of hematopoietic disorders. The degree of complexity relates not only to the intrinsic pathobiological characteristics of the disease, but also to the group of patients whom it affects most frequently: older individuals or those who have been exposed to prior forms of chemotherapy. It is therefore crucial to develop clinical tools to predict with a certain degree of precision the prognosis and outcome for patients with specific subtypes of MDS in specific clinical situations. At the present time, patients with MDS are diagnosed using a set of well-established histopathological criteria. Prognosis is established using classifications that include morphological features, percentage of blasts, and clinical and molecular characteristics such as peripheral cytopenias and cytogenetics. The International Prognostic Scoring System (IPSS) is a classic example of this type of classification. Over the last 5 years, there has been an intense effort to develop new prognostic systems for MDS, and new molecular alterations with potential prognostic value have been discovered. Over the same period of time, several new therapeutic interventions have been developed for patients with MDS. Biomarkers of response to these agents, in particular for the hypomethylating agents, are needed to predict clinical benefit. This review summarizes current prognostic models of MDS and new molecular alterations with potential prognostic potential.

scholarly journals Pregnancy Outcomes in Chronic Myeloid Leukemia: A Single Center Experience

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Irappa Madabhavi ◽  
Malay Sarkar ◽  
Mitul Modi ◽  
Nagaveni Kadakol
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Pregnancy Outcomes ◽  
Myeloid Leukemia ◽  
Cytogenetic Response ◽  
Full Term ◽  
Term Pregnancy ◽  
Normal Delivery ◽  
Total N ◽  
Female Patients ◽  
Complete Cytogenetic Response

PURPOSE The aim of the current work was to report the effect of imatinib on pregnancy in patients with chronic myeloid leukemia (CML). METHODS Data were collected between January 1998 and December 2014. One hundred four patients met inclusion criteria, and we report the results of 104 pregnancies—conceived by the participant or partner—while being on imatinib therapy for CML. RESULTS Fifty-eight patients were male and 46 were female. Eighty-three patients, 20 patients, and one patient were had CML in the chronic phase, accelerated phase, or blast phase, respectively. Of 46 female patients, 21 underwent abortion (spontaneous, n = 36.9; elective termination, n = 8.6%). In the case of full-term pregnancy in the female partners of male patients with CML, all outcomes were uneventful. Of 46 female patients, 25 had full-term pregnancy outcomes. During the pre–imatinib era (total n = 6), patients were treated with hydroxyurea, interferon-alpha, and therapeutic leukapheresis. A total 10 of 19 pregnant patients continued on imatinib until their delivery and experienced the following outcomes: normal full-term deliveries (n = 7), preterm delivery (n = 1), omphalocele (n = 1), and craniosynostosis (n = 1). Of those who discontinued imatinib after counseling (n = 9), eight patients had full-term normal delivery, of which two patients required leukapheresis and one patient expired. All patients who continued on imatinib while pregnant were in complete cytogenetic response and major molecular response (MMR) before pregnancy, during pregnancy, and postpregnancy. Of nine patients who discontinued imatinib, two lost MMR during the third trimester and all of these patients were in complete cytogenetic response and MMR before pregnancy. CONCLUSION It is clear that there is no standard of care for the best treatment of CML in the case of pregnancy. Interferon and/or leukapheresis will be included as treatment options. Patients can have normal pregnancies even with the administration of imatinib at the risk of congenital anomalies, intervention for which can be done after birth.

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