Hypomethylating agents (HMAs) improve survival in patients with higher-risk myelodysplastic syndromes (MDS) but are less well-studied in lower-risk disease. We compared the safety and efficacy of low-dose decitabine versus low-dose azacitidine in this group of patients.
Adults with low- or intermediate-1-risk MDS or MDS/myeloproliferative neoplasm (MPN), including chronic myelomonocytic leukemia, by the International Prognostic Scoring System were randomized using a Bayesian adaptive design to receive either azacitidine 75 mg/m(2) IV/SC daily or decitabine 20 mg/m(2) IV daily for 3 consecutive days on a 28-day cycle. The primary outcome was overall response rate (ORR).
Between 11/2012 and 2/2016, 113 patients were treated, 40 (35%) with azacitidine and 73 (65%) with decitabine. The median age was 70 years; 81% of patients were intermediate-1-risk. The median number of cycles received was 9. The overall response rate was 70% and 49% (p=0.03) for patients treated with decitabine and azacitidine, respectively. Thirty-two percent of patients treated with decitabine became transfusion independent compared with 16% of patients treated with azacitidine (p=0.2). Cytogenetic response rates were 61% and 25% (p=0.02), respectively. With a median follow-up of 20 months, the overall median event-free survival was 18 months -- 20 and 13 months for patients treated with decitabine and azacitidine, respectively (p=0.1). Treatment was well tolerated with a 6-week mortality rate of 0%.
The use of low-dose HMAs is safe and effective in patients with lower-risk MDS and MDS/MPN. Their impact on the natural history of lower-risk disease needs to be further studied. This trial was registered at clinicaltrials.gov (identifier NCT01720225).
Pharmacology, Toxicology and Pharmaceutical Science
6
4%
Agricultural and Biological Sciences
5
3%
Nursing and Health Professions
3
2%
Other
12
8%
Unknown
55
37%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 29. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 May 2024.
All research outputs
#1,613,738
of 31,393,817 outputs
Outputs from Blood
#1,604
of 42,311 outputs
Outputs of similar age
#24,756
of 342,024 outputs
Outputs of similar age from Blood
#30
of 257 outputs
Altmetric has tracked 31,393,817 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 42,311 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.3. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 342,024 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 257 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.
