Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine
Abstract Background Hypomethylating agents, including azacytidine (AZA), are standard therapeutics for patients with high‐risk myelodysplastic syndromes (MDS), a group of myeloid neoplasms. However, treatment schedules are not unified in real‐world practice; in addition to the standard 7‐day (standa...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Cancer Reports |
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| Online Access: | https://doi.org/10.1002/cnr2.1938 |
| _version_ | 1797344855752441856 |
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| author | Shinichi Ogawa Tatsuhiro Sakamoto Ryota Matsuoka Kantaro Ishitsuka Yasuko Ogino Ayano Sootome Kenichi Makishima Chikashi Yoshida Yufu Ito Seiichi Shimizu Takuya Suyama Atsushi Shinagawa Takayoshi Ito Naoshi Obara Manabu Kusakabe Mamiko Sakata‐Yanagimoto Yasushi Miyazaki Yasuhito Nannya Shigeru Chiba |
| author_facet | Shinichi Ogawa Tatsuhiro Sakamoto Ryota Matsuoka Kantaro Ishitsuka Yasuko Ogino Ayano Sootome Kenichi Makishima Chikashi Yoshida Yufu Ito Seiichi Shimizu Takuya Suyama Atsushi Shinagawa Takayoshi Ito Naoshi Obara Manabu Kusakabe Mamiko Sakata‐Yanagimoto Yasushi Miyazaki Yasuhito Nannya Shigeru Chiba |
| author_sort | Shinichi Ogawa |
| collection | DOAJ |
| description | Abstract Background Hypomethylating agents, including azacytidine (AZA), are standard therapeutics for patients with high‐risk myelodysplastic syndromes (MDS), a group of myeloid neoplasms. However, treatment schedules are not unified in real‐world practice; in addition to the standard 7‐day (standard‐dose) schedule, shortened (reduced‐dose) schedules are also used. Aims The aim of this study was to discover the patient group(s) which show differential efficacy between standard‐and reduced‐dose AZA to MDS. Methods and Results The outcome of different AZA doses in a cohort of 151 MDS patients were retrospectively analyzed. Overall survival (OS) was not significantly different between standard‐ and reduced‐dose AZA groups by multivariate analysis. However, an interaction was found between either the sex (female vs. male), the platelet counts (< 40 × 103/μl vs. ≥ 40 × 103/μl), or the karyotype risk (< poor vs. ≥ poor) and standard‐dose AZA for longer OS. Subgroup analyses revealed better OS with standard‐ over reduced‐dose AZA in female patients (HR, 0.27 [95% CI, 0.090‐0.79]; p = 0.011), and those with platelet counts ≥ 40 × 103/μl (HR, 0.51 [95% CI, 0.26‐0.99]; p = 0.041). The union of female and preserved platelet count subgroups also benefited from standard‐dose AZA. With this as a test cohort, we next analyzed patients registered in the JALSG MDS212 study, for whom 7‐day and 5‐day AZA treatment strategies were prospectively compared, as a validation cohort (N = 172). That cohort showed the same tendency as the retrospective results. Conclusion We identified the union of female and preserved platelet count subgroups which benefited from standard‐dose AZA, imparting crucial information to physicians planning treatment regimens in MDS patients. |
| first_indexed | 2024-03-08T11:08:57Z |
| format | Article |
| id | doaj.art-f09fa49297404012bf6c2f22d92a991c |
| institution | Directory Open Access Journal |
| issn | 2573-8348 |
| language | English |
| last_indexed | 2024-03-08T11:08:57Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Reports |
| spelling | doaj.art-f09fa49297404012bf6c2f22d92a991c2024-01-26T14:25:02ZengWileyCancer Reports2573-83482024-01-0171n/an/a10.1002/cnr2.1938Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidineShinichi Ogawa0Tatsuhiro Sakamoto1Ryota Matsuoka2Kantaro Ishitsuka3Yasuko Ogino4Ayano Sootome5Kenichi Makishima6Chikashi Yoshida7Yufu Ito8Seiichi Shimizu9Takuya Suyama10Atsushi Shinagawa11Takayoshi Ito12Naoshi Obara13Manabu Kusakabe14Mamiko Sakata‐Yanagimoto15Yasushi Miyazaki16Yasuhito Nannya17Shigeru Chiba18Division of Hematology JA Toride General Medical Center Toride, Ibaraki JapanDepartment of Hematology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanDepartment of Pathology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanGraduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba, Ibaraki JapanDivision of Hematology JA Toride General Medical Center Toride, Ibaraki JapanDepartment of Hematology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanGraduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba, Ibaraki JapanDivision of Hematology National Hospital Organization Mito Medical Center Mito, Ibaraki JapanDivision of Hematology Tsuchiura Kyoudou General Hospital Tsuchiura, Ibaraki JapanDivision of Hematology Tsuchiura Kyoudou General Hospital Tsuchiura, Ibaraki JapanDivision of Hematology Hitachi General Hospital Hitachi, Ibaraki JapanDivision of Hematology Hitachi General Hospital Hitachi, Ibaraki JapanDivision of Hematology JA Toride General Medical Center Toride, Ibaraki JapanDepartment of Hematology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanDepartment of Hematology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanDepartment of Hematology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanDepartment of Hematology Atomic Bomb Disease Institute, Nagasaki University Nagasaki JapanDepartment of Hematology Institute of Medical Science, University of Tokyo Tokyo JapanDepartment of Hematology, Faculty of Medicine University of Tsukuba Tsukuba, Ibaraki JapanAbstract Background Hypomethylating agents, including azacytidine (AZA), are standard therapeutics for patients with high‐risk myelodysplastic syndromes (MDS), a group of myeloid neoplasms. However, treatment schedules are not unified in real‐world practice; in addition to the standard 7‐day (standard‐dose) schedule, shortened (reduced‐dose) schedules are also used. Aims The aim of this study was to discover the patient group(s) which show differential efficacy between standard‐and reduced‐dose AZA to MDS. Methods and Results The outcome of different AZA doses in a cohort of 151 MDS patients were retrospectively analyzed. Overall survival (OS) was not significantly different between standard‐ and reduced‐dose AZA groups by multivariate analysis. However, an interaction was found between either the sex (female vs. male), the platelet counts (< 40 × 103/μl vs. ≥ 40 × 103/μl), or the karyotype risk (< poor vs. ≥ poor) and standard‐dose AZA for longer OS. Subgroup analyses revealed better OS with standard‐ over reduced‐dose AZA in female patients (HR, 0.27 [95% CI, 0.090‐0.79]; p = 0.011), and those with platelet counts ≥ 40 × 103/μl (HR, 0.51 [95% CI, 0.26‐0.99]; p = 0.041). The union of female and preserved platelet count subgroups also benefited from standard‐dose AZA. With this as a test cohort, we next analyzed patients registered in the JALSG MDS212 study, for whom 7‐day and 5‐day AZA treatment strategies were prospectively compared, as a validation cohort (N = 172). That cohort showed the same tendency as the retrospective results. Conclusion We identified the union of female and preserved platelet count subgroups which benefited from standard‐dose AZA, imparting crucial information to physicians planning treatment regimens in MDS patients.https://doi.org/10.1002/cnr2.1938azacitidinedosemyelodysplastic syndromeplatelet countssex |
| spellingShingle | Shinichi Ogawa Tatsuhiro Sakamoto Ryota Matsuoka Kantaro Ishitsuka Yasuko Ogino Ayano Sootome Kenichi Makishima Chikashi Yoshida Yufu Ito Seiichi Shimizu Takuya Suyama Atsushi Shinagawa Takayoshi Ito Naoshi Obara Manabu Kusakabe Mamiko Sakata‐Yanagimoto Yasushi Miyazaki Yasuhito Nannya Shigeru Chiba Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine Cancer Reports azacitidine dose myelodysplastic syndrome platelet counts sex |
| title | Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine |
| title_full | Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine |
| title_fullStr | Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine |
| title_full_unstemmed | Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine |
| title_short | Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard‐dose azacitidine |
| title_sort | female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard dose azacitidine |
| topic | azacitidine dose myelodysplastic syndrome platelet counts sex |
| url | https://doi.org/10.1002/cnr2.1938 |
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