1. Survival benefits with transplantation in secondary AML evolving from myelodysplastic syndrome with hypomethylating treatment failure.
- Author
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Shin, S-H, Yahng, S-A, Yoon, J-H, Lee, S-E, Cho, B-S, Eom, K-S, Lee, S, Min, C-K, Kim, H-J, Cho, S-G, Kim, D-W, Lee, J-W, Min, W-S, Park, C-W, and Kim, Y-J
- Subjects
MYELODYSPLASTIC syndromes ,RETROSPECTIVE studies ,MULTIVARIATE analysis ,HEMATOPOIETIC stem cells ,AZACITIDINE ,DIAGNOSIS - Abstract
The prognosis for patients with myelodysplastic syndrome with hypomethylating treatment failure (MDS-HTF) has been known to be poor. However, the clinical outcomes and optimal treatment options for secondary AML evolving from MDS-HTF (sAML/MDS-HTF) are not well known. This retrospective analysis was conducted to evaluate the clinical outcomes and influences of treatment options on survival in 46 consecutive patients with sAML/MDS-HTF. The median OS rates were 1.4 months in the best supportive care group (n=15) and 9.4 months in the active treatment group (n=31). One-year OS rates were 13.3% and 36.8%, respectively (P=0.001). Active treatment (P<0.001), lower BM blast (<33%) at sAML (P=0.007), non-poor NCCN (National Cancer Comprehensive Network) cytogenetics (P=0.001) and good performance status (ECOG (Eastern Cooperative Oncology Group) 1) (P=0.024) were significant predictors affecting favorable OS in a multivariate analysis. Of the active treatment options, allo-SCT with prior chemotherapy (CTx) showed better OS compared with CTx only or SCT without CTx (P=0.019). Our analyses suggest that active treatment, particularly SCT following CTx, should be considered in patients with sAML/MDS-HTF if the patient is medically fit. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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