A RETROSPECTIVE REVIEW OF AZACITIDINE THERAPY IN AN IRISH UNIVERSITY HOSPITAL SETTING
(Abstract release date: 05/19/16)
EHA Library. Nolan J. 06/09/16; 134832; PB1932
Dr. James Nolan
Contributions
Contributions
Abstract
Abstract: PB1932
Type: Publication Only
Background
Azacitidine (AZA) is a a hypomethylating agent and nucleoside analogue of cytidine. Hypomethylating agents have revolutionised the therapy of intermediate-2 and high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML) in patients fit for neither intensive therapy nor haematopoietic stem cell transplantation (HSCT).
Aims
This retrospective review aimed to examine the usage of AZA commenced for any indication during a three year period in a university teaching hospital in Ireland. Data collected pertained to patient and disease characteristics, safety, efficacy, overall and progression free survival and the effect of therapy on transfusion dependence.
Methods
A retrospective analysis of patients receiving AZA at University Hospital Limerick in a three year period from October 2012 until October 2015 was conducted. Data was collected from patients’ paper and electronic records and the electronic laboratory system. Included patients received at least one cycle of AZA. The World Health Organization Classification was used to classify disease status. Overall (OS) and progression-free survival (PFS) were calculated from the date of commencement of AZA therapy and were calculated using Kaplan-Meier estimates.
Results
Twenty-eight (28) patients commenced AZA between October 2012 and October 2015. 64% of patients were male and the cohort had a median age of 70 years (range 42-80 years). These patients comprised 3 patients with IPSS intermediate risk (level 2) MDS, 5 patients with IPSS high-risk MDS, 6 patients with CMML, 2 patients with MDS/MPN overlap, 1 patient with hypoplastic MDS, 1 patient with refractory anaemia with ring sideroblasts (RARS-MDS) and 10 patients with AML. Of the 10 patients with AML, 4 patients had 20-30% bone marrow myeloblasts confirmed morphologically and by flow cytometry and 6 patients had >30% blasts. 26 patients (93%) were transplant-ineligible due to age or comorbidity and 2 had received previous reduced intensity haemopoietic stem cell transplantation. An additional 2 patients had received prior intensive induction chemotherapy for AML. 55% of patients responded to therapy including achievement of stable disease. 66% of patients required red cell support initially, of whom 37% achieved red cell independence. CTCAE grade 3 or 4 toxicities were mostly haematological, with 66% of patients experiencing same. 52% of patients required at least one admission during AZA therapy, predominantly for severe infections (88%). Median OS and PFS were as follows: AML 9.4 months and 8.7 months, high-risk MDS 3 months and 2.6 months and CMML 8 months and 4.5 months.
Conclusion
AZA improved OS for patients with AML who were ineligible for intensive therapy or HSCT in our institution. AZA was well tolerated in general and brought about transfusion independence in 37% of transfusion-dependent patients. The most significant toxicities were haematological and relating to severe infection, often requiring hospital admission. Hypomethylating agents continue to provide an excellent therapeutic option for these difficult-to-treat patients.
Session topic: E-poster
Keyword(s): AML, Hypomethylation, MDS/AML
Type: Publication Only
Background
Azacitidine (AZA) is a a hypomethylating agent and nucleoside analogue of cytidine. Hypomethylating agents have revolutionised the therapy of intermediate-2 and high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML) in patients fit for neither intensive therapy nor haematopoietic stem cell transplantation (HSCT).
Aims
This retrospective review aimed to examine the usage of AZA commenced for any indication during a three year period in a university teaching hospital in Ireland. Data collected pertained to patient and disease characteristics, safety, efficacy, overall and progression free survival and the effect of therapy on transfusion dependence.
Methods
A retrospective analysis of patients receiving AZA at University Hospital Limerick in a three year period from October 2012 until October 2015 was conducted. Data was collected from patients’ paper and electronic records and the electronic laboratory system. Included patients received at least one cycle of AZA. The World Health Organization Classification was used to classify disease status. Overall (OS) and progression-free survival (PFS) were calculated from the date of commencement of AZA therapy and were calculated using Kaplan-Meier estimates.
Results
Twenty-eight (28) patients commenced AZA between October 2012 and October 2015. 64% of patients were male and the cohort had a median age of 70 years (range 42-80 years). These patients comprised 3 patients with IPSS intermediate risk (level 2) MDS, 5 patients with IPSS high-risk MDS, 6 patients with CMML, 2 patients with MDS/MPN overlap, 1 patient with hypoplastic MDS, 1 patient with refractory anaemia with ring sideroblasts (RARS-MDS) and 10 patients with AML. Of the 10 patients with AML, 4 patients had 20-30% bone marrow myeloblasts confirmed morphologically and by flow cytometry and 6 patients had >30% blasts. 26 patients (93%) were transplant-ineligible due to age or comorbidity and 2 had received previous reduced intensity haemopoietic stem cell transplantation. An additional 2 patients had received prior intensive induction chemotherapy for AML. 55% of patients responded to therapy including achievement of stable disease. 66% of patients required red cell support initially, of whom 37% achieved red cell independence. CTCAE grade 3 or 4 toxicities were mostly haematological, with 66% of patients experiencing same. 52% of patients required at least one admission during AZA therapy, predominantly for severe infections (88%). Median OS and PFS were as follows: AML 9.4 months and 8.7 months, high-risk MDS 3 months and 2.6 months and CMML 8 months and 4.5 months.
Conclusion
AZA improved OS for patients with AML who were ineligible for intensive therapy or HSCT in our institution. AZA was well tolerated in general and brought about transfusion independence in 37% of transfusion-dependent patients. The most significant toxicities were haematological and relating to severe infection, often requiring hospital admission. Hypomethylating agents continue to provide an excellent therapeutic option for these difficult-to-treat patients.
Session topic: E-poster
Keyword(s): AML, Hypomethylation, MDS/AML
Abstract: PB1932
Type: Publication Only
Background
Azacitidine (AZA) is a a hypomethylating agent and nucleoside analogue of cytidine. Hypomethylating agents have revolutionised the therapy of intermediate-2 and high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML) in patients fit for neither intensive therapy nor haematopoietic stem cell transplantation (HSCT).
Aims
This retrospective review aimed to examine the usage of AZA commenced for any indication during a three year period in a university teaching hospital in Ireland. Data collected pertained to patient and disease characteristics, safety, efficacy, overall and progression free survival and the effect of therapy on transfusion dependence.
Methods
A retrospective analysis of patients receiving AZA at University Hospital Limerick in a three year period from October 2012 until October 2015 was conducted. Data was collected from patients’ paper and electronic records and the electronic laboratory system. Included patients received at least one cycle of AZA. The World Health Organization Classification was used to classify disease status. Overall (OS) and progression-free survival (PFS) were calculated from the date of commencement of AZA therapy and were calculated using Kaplan-Meier estimates.
Results
Twenty-eight (28) patients commenced AZA between October 2012 and October 2015. 64% of patients were male and the cohort had a median age of 70 years (range 42-80 years). These patients comprised 3 patients with IPSS intermediate risk (level 2) MDS, 5 patients with IPSS high-risk MDS, 6 patients with CMML, 2 patients with MDS/MPN overlap, 1 patient with hypoplastic MDS, 1 patient with refractory anaemia with ring sideroblasts (RARS-MDS) and 10 patients with AML. Of the 10 patients with AML, 4 patients had 20-30% bone marrow myeloblasts confirmed morphologically and by flow cytometry and 6 patients had >30% blasts. 26 patients (93%) were transplant-ineligible due to age or comorbidity and 2 had received previous reduced intensity haemopoietic stem cell transplantation. An additional 2 patients had received prior intensive induction chemotherapy for AML. 55% of patients responded to therapy including achievement of stable disease. 66% of patients required red cell support initially, of whom 37% achieved red cell independence. CTCAE grade 3 or 4 toxicities were mostly haematological, with 66% of patients experiencing same. 52% of patients required at least one admission during AZA therapy, predominantly for severe infections (88%). Median OS and PFS were as follows: AML 9.4 months and 8.7 months, high-risk MDS 3 months and 2.6 months and CMML 8 months and 4.5 months.
Conclusion
AZA improved OS for patients with AML who were ineligible for intensive therapy or HSCT in our institution. AZA was well tolerated in general and brought about transfusion independence in 37% of transfusion-dependent patients. The most significant toxicities were haematological and relating to severe infection, often requiring hospital admission. Hypomethylating agents continue to provide an excellent therapeutic option for these difficult-to-treat patients.
Session topic: E-poster
Keyword(s): AML, Hypomethylation, MDS/AML
Type: Publication Only
Background
Azacitidine (AZA) is a a hypomethylating agent and nucleoside analogue of cytidine. Hypomethylating agents have revolutionised the therapy of intermediate-2 and high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML) in patients fit for neither intensive therapy nor haematopoietic stem cell transplantation (HSCT).
Aims
This retrospective review aimed to examine the usage of AZA commenced for any indication during a three year period in a university teaching hospital in Ireland. Data collected pertained to patient and disease characteristics, safety, efficacy, overall and progression free survival and the effect of therapy on transfusion dependence.
Methods
A retrospective analysis of patients receiving AZA at University Hospital Limerick in a three year period from October 2012 until October 2015 was conducted. Data was collected from patients’ paper and electronic records and the electronic laboratory system. Included patients received at least one cycle of AZA. The World Health Organization Classification was used to classify disease status. Overall (OS) and progression-free survival (PFS) were calculated from the date of commencement of AZA therapy and were calculated using Kaplan-Meier estimates.
Results
Twenty-eight (28) patients commenced AZA between October 2012 and October 2015. 64% of patients were male and the cohort had a median age of 70 years (range 42-80 years). These patients comprised 3 patients with IPSS intermediate risk (level 2) MDS, 5 patients with IPSS high-risk MDS, 6 patients with CMML, 2 patients with MDS/MPN overlap, 1 patient with hypoplastic MDS, 1 patient with refractory anaemia with ring sideroblasts (RARS-MDS) and 10 patients with AML. Of the 10 patients with AML, 4 patients had 20-30% bone marrow myeloblasts confirmed morphologically and by flow cytometry and 6 patients had >30% blasts. 26 patients (93%) were transplant-ineligible due to age or comorbidity and 2 had received previous reduced intensity haemopoietic stem cell transplantation. An additional 2 patients had received prior intensive induction chemotherapy for AML. 55% of patients responded to therapy including achievement of stable disease. 66% of patients required red cell support initially, of whom 37% achieved red cell independence. CTCAE grade 3 or 4 toxicities were mostly haematological, with 66% of patients experiencing same. 52% of patients required at least one admission during AZA therapy, predominantly for severe infections (88%). Median OS and PFS were as follows: AML 9.4 months and 8.7 months, high-risk MDS 3 months and 2.6 months and CMML 8 months and 4.5 months.
Conclusion
AZA improved OS for patients with AML who were ineligible for intensive therapy or HSCT in our institution. AZA was well tolerated in general and brought about transfusion independence in 37% of transfusion-dependent patients. The most significant toxicities were haematological and relating to severe infection, often requiring hospital admission. Hypomethylating agents continue to provide an excellent therapeutic option for these difficult-to-treat patients.
Session topic: E-poster
Keyword(s): AML, Hypomethylation, MDS/AML
{{ help_message }}
{{filter}}