Azacytidine Failure Revisited: An Appraisal Based on Real Life Data from the MDS Registry of the Hellenic Myelodysplastic Syndrome Study Group (HMDS)

Azacytidine (AZA) is the mainstay of treatment for high-risk MDS, but both primary and secondary AZA failure confers a grave prognosis. Given the limited availability and efficacy of subsequent treatment options the exact definition of AZA failure and the decision to discontinue AZA is of particular importance in everyday clinical practice. However, the current definition of AZA failure is rather obscure and often lumps together pathobiologically diverse disease states, as reflected by the highly heterogeneous outcome of patients who fail AZA (post-HMA model, Nazha A et al, 2016).