FAVORABLE OUTCOMES WITH TUMOR BURDEN REDUCTION WITH HYPOMETHYLATING AGENTS BEFORE ALLOGENEIC HEMATOPOIETIC CELL TRANSPLNATATION FOR PATIENTS WITH HIGHER RISK MYELODYSPLASTIC SYNDROME
(Abstract release date: 05/19/16)
EHA Library. Park S. 06/09/16; 132771; E1222
Sungwoo Park
Contributions
Contributions
Abstract
Abstract: E1222
Type: Eposter Presentation
Background
The use of hypomythylating agents (HMA) have improved the outcomes of myelodysplastic syndrome (MDS) in terms of hematologic improvement and long-term survival. HMA treatment while awaiting allogeneic hematopoietic cell transplantation (allo-HCT) or as a purpose of cytoreduction for higher risk MDS can be an attractive option with the hope of successful cytoreduction before allo-SCT. However, the role of induction response or cytoreduction for the patients with higher risk myelodysplastic syndrome (MDS) is not yet clearly defined.
Aims
In this sutdy, the clinical significance of tumor burden and transition of IPSS risk group for transplant eligible patients with higher risk MDS were evaluated.
Methods
The data of 79 transplant eligible patients (< 65 years old) diagnosed with higher-risk MDS from Jan 1992 to Mar 2013 and received HMA as frontline therapy were retrospectively analyzed. To evaluate the effects of the tumor burden on treatment outcomes, treatment response (responder vs non-responder), IPSS risk group after HMA treatment, transition of IPSS risk group, and blast percentage in bone marrow after HMA treatment were evaluated
Results
Among 79 patients, 30 patients (38.0%) performed allo-HCT (HCT group) and 49 patiens (62.0%) treated with HMA without allo-HCT (non-HCT group). Median follow-up duration was 778 days (range 143-2921 days) and 375 days (range 7-6561 days) in HCT group and non-HCT group, respectively (p=0.001). Three-year overall survival (OS) rate was significantly higher with HCT group (47.0±12.1%) than non-HCT group (19.6±7.0%, p<0.001), which confirmes the the role of allo-HCT for patients with higher risk MDS. For HCT group, the short duration until allo-HCT showed a better outcomes as regards OS (p=0.035). In the multivariage analysis, blast percentage ≥10% in bone marrow (HR 2.569, 95% CI 1.116-5.916, p=0.027) and IPSS higher risk prior to allo-HCT (HR 5.371, 95% CI 1.886-15.291, p=0.002) were found to be significantly correlated with the OS. However, IPSS transition did not affect the long-term outcomes (HR 0.703, 95% CI 0.079-6.285, p=0.752).
Conclusion
To predict the clinical outcomes of patients with higher risk MDS, the optimal time for tumor burden evaluation is prior to allo-HCT than at the time of initial diagnosis. For those with lower blasts in the BM or lower IPSS risk group were related with favorable OS. However, as early performance of allo-HCT was associated with favorable OS and IPSS transition did not affect the OS, it may not be resonable to delay allo-HCT to achieve better response to HMA for those who are planning to allo-HCT.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Hypomethylation, MDS
Type: Eposter Presentation
Background
The use of hypomythylating agents (HMA) have improved the outcomes of myelodysplastic syndrome (MDS) in terms of hematologic improvement and long-term survival. HMA treatment while awaiting allogeneic hematopoietic cell transplantation (allo-HCT) or as a purpose of cytoreduction for higher risk MDS can be an attractive option with the hope of successful cytoreduction before allo-SCT. However, the role of induction response or cytoreduction for the patients with higher risk myelodysplastic syndrome (MDS) is not yet clearly defined.
Aims
In this sutdy, the clinical significance of tumor burden and transition of IPSS risk group for transplant eligible patients with higher risk MDS were evaluated.
Methods
The data of 79 transplant eligible patients (< 65 years old) diagnosed with higher-risk MDS from Jan 1992 to Mar 2013 and received HMA as frontline therapy were retrospectively analyzed. To evaluate the effects of the tumor burden on treatment outcomes, treatment response (responder vs non-responder), IPSS risk group after HMA treatment, transition of IPSS risk group, and blast percentage in bone marrow after HMA treatment were evaluated
Results
Among 79 patients, 30 patients (38.0%) performed allo-HCT (HCT group) and 49 patiens (62.0%) treated with HMA without allo-HCT (non-HCT group). Median follow-up duration was 778 days (range 143-2921 days) and 375 days (range 7-6561 days) in HCT group and non-HCT group, respectively (p=0.001). Three-year overall survival (OS) rate was significantly higher with HCT group (47.0±12.1%) than non-HCT group (19.6±7.0%, p<0.001), which confirmes the the role of allo-HCT for patients with higher risk MDS. For HCT group, the short duration until allo-HCT showed a better outcomes as regards OS (p=0.035). In the multivariage analysis, blast percentage ≥10% in bone marrow (HR 2.569, 95% CI 1.116-5.916, p=0.027) and IPSS higher risk prior to allo-HCT (HR 5.371, 95% CI 1.886-15.291, p=0.002) were found to be significantly correlated with the OS. However, IPSS transition did not affect the long-term outcomes (HR 0.703, 95% CI 0.079-6.285, p=0.752).
Conclusion
To predict the clinical outcomes of patients with higher risk MDS, the optimal time for tumor burden evaluation is prior to allo-HCT than at the time of initial diagnosis. For those with lower blasts in the BM or lower IPSS risk group were related with favorable OS. However, as early performance of allo-HCT was associated with favorable OS and IPSS transition did not affect the OS, it may not be resonable to delay allo-HCT to achieve better response to HMA for those who are planning to allo-HCT.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Hypomethylation, MDS
Abstract: E1222
Type: Eposter Presentation
Background
The use of hypomythylating agents (HMA) have improved the outcomes of myelodysplastic syndrome (MDS) in terms of hematologic improvement and long-term survival. HMA treatment while awaiting allogeneic hematopoietic cell transplantation (allo-HCT) or as a purpose of cytoreduction for higher risk MDS can be an attractive option with the hope of successful cytoreduction before allo-SCT. However, the role of induction response or cytoreduction for the patients with higher risk myelodysplastic syndrome (MDS) is not yet clearly defined.
Aims
In this sutdy, the clinical significance of tumor burden and transition of IPSS risk group for transplant eligible patients with higher risk MDS were evaluated.
Methods
The data of 79 transplant eligible patients (< 65 years old) diagnosed with higher-risk MDS from Jan 1992 to Mar 2013 and received HMA as frontline therapy were retrospectively analyzed. To evaluate the effects of the tumor burden on treatment outcomes, treatment response (responder vs non-responder), IPSS risk group after HMA treatment, transition of IPSS risk group, and blast percentage in bone marrow after HMA treatment were evaluated
Results
Among 79 patients, 30 patients (38.0%) performed allo-HCT (HCT group) and 49 patiens (62.0%) treated with HMA without allo-HCT (non-HCT group). Median follow-up duration was 778 days (range 143-2921 days) and 375 days (range 7-6561 days) in HCT group and non-HCT group, respectively (p=0.001). Three-year overall survival (OS) rate was significantly higher with HCT group (47.0±12.1%) than non-HCT group (19.6±7.0%, p<0.001), which confirmes the the role of allo-HCT for patients with higher risk MDS. For HCT group, the short duration until allo-HCT showed a better outcomes as regards OS (p=0.035). In the multivariage analysis, blast percentage ≥10% in bone marrow (HR 2.569, 95% CI 1.116-5.916, p=0.027) and IPSS higher risk prior to allo-HCT (HR 5.371, 95% CI 1.886-15.291, p=0.002) were found to be significantly correlated with the OS. However, IPSS transition did not affect the long-term outcomes (HR 0.703, 95% CI 0.079-6.285, p=0.752).
Conclusion
To predict the clinical outcomes of patients with higher risk MDS, the optimal time for tumor burden evaluation is prior to allo-HCT than at the time of initial diagnosis. For those with lower blasts in the BM or lower IPSS risk group were related with favorable OS. However, as early performance of allo-HCT was associated with favorable OS and IPSS transition did not affect the OS, it may not be resonable to delay allo-HCT to achieve better response to HMA for those who are planning to allo-HCT.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Hypomethylation, MDS
Type: Eposter Presentation
Background
The use of hypomythylating agents (HMA) have improved the outcomes of myelodysplastic syndrome (MDS) in terms of hematologic improvement and long-term survival. HMA treatment while awaiting allogeneic hematopoietic cell transplantation (allo-HCT) or as a purpose of cytoreduction for higher risk MDS can be an attractive option with the hope of successful cytoreduction before allo-SCT. However, the role of induction response or cytoreduction for the patients with higher risk myelodysplastic syndrome (MDS) is not yet clearly defined.
Aims
In this sutdy, the clinical significance of tumor burden and transition of IPSS risk group for transplant eligible patients with higher risk MDS were evaluated.
Methods
The data of 79 transplant eligible patients (< 65 years old) diagnosed with higher-risk MDS from Jan 1992 to Mar 2013 and received HMA as frontline therapy were retrospectively analyzed. To evaluate the effects of the tumor burden on treatment outcomes, treatment response (responder vs non-responder), IPSS risk group after HMA treatment, transition of IPSS risk group, and blast percentage in bone marrow after HMA treatment were evaluated
Results
Among 79 patients, 30 patients (38.0%) performed allo-HCT (HCT group) and 49 patiens (62.0%) treated with HMA without allo-HCT (non-HCT group). Median follow-up duration was 778 days (range 143-2921 days) and 375 days (range 7-6561 days) in HCT group and non-HCT group, respectively (p=0.001). Three-year overall survival (OS) rate was significantly higher with HCT group (47.0±12.1%) than non-HCT group (19.6±7.0%, p<0.001), which confirmes the the role of allo-HCT for patients with higher risk MDS. For HCT group, the short duration until allo-HCT showed a better outcomes as regards OS (p=0.035). In the multivariage analysis, blast percentage ≥10% in bone marrow (HR 2.569, 95% CI 1.116-5.916, p=0.027) and IPSS higher risk prior to allo-HCT (HR 5.371, 95% CI 1.886-15.291, p=0.002) were found to be significantly correlated with the OS. However, IPSS transition did not affect the long-term outcomes (HR 0.703, 95% CI 0.079-6.285, p=0.752).
Conclusion
To predict the clinical outcomes of patients with higher risk MDS, the optimal time for tumor burden evaluation is prior to allo-HCT than at the time of initial diagnosis. For those with lower blasts in the BM or lower IPSS risk group were related with favorable OS. However, as early performance of allo-HCT was associated with favorable OS and IPSS transition did not affect the OS, it may not be resonable to delay allo-HCT to achieve better response to HMA for those who are planning to allo-HCT.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Hypomethylation, MDS
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