Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents

Elias Jabbour, Paolo Strati, Monica Cabrero, Susan O'Brien, Farhad Ravandi, Carlos Bueso-Ramos, Qiao Wei, Jianhua Hu, Simon Abi Aad, Nicholas J. Short, Courtney Dinardo, Naval Daver, Tapan Kadia, William Wierda, Yue Wei, Simona Colla, Gautam Borthakur, Jorge Cortes, Zeev Estrov, Hagop KantarjianGuillermo Garcia-Manero

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6 Scopus citations

Abstract

Two hundred and sixteen consecutive patients with MDS and abnormal karyotype treated with hypomethylating agents between 4/04 and 10/12 were reviewed. Median follow-up was 17 months. Using IWG criteria, best responses were complete response (CR) in 79 patients (37%), partial response (PR) in 4 (2%), and hematologic improvement (HI) in 10 (5%). Cytogenetic response (CyR) was achieved in 78 patients (36%): complete (CCyR) in 62 (29%) and partial in 16 (7%). CyR was achieved in 48 of 79 patients (61%) with CR, 1 of 14 (7%) with PR/HI, and in 29 of the 123 (24%) with no morphologic response. Median overall survival (OS) and leukemia-free survival (LFS) for patients with and without CCyR were 21 and 13 months (P =.007), and 16 and 9 months (P =.001), respectively. By multivariate analysis, the achievement of CCyR was predictive for better OS (HR = 2.1; P <.001). In conclusion, CyR occurs at a rate of 36% (complete in 29%) in patients with MDS treated with HMA and is not always associated with morphological response. The achievement of CCyR is associated with survival improvement and constitutes a major predictive factor for outcome particularly in patients without morphologic response. Therefore, the achievement of CCyR should be considered a milestone in the management of patients with MDS.

Original languageEnglish (US)
Pages (from-to)351-358
Number of pages8
JournalAmerican Journal of Hematology
Volume92
Issue number4
DOIs
StatePublished - Apr 1 2017

ASJC Scopus subject areas

  • Hematology

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    Jabbour, E., Strati, P., Cabrero, M., O'Brien, S., Ravandi, F., Bueso-Ramos, C., Wei, Q., Hu, J., Abi Aad, S., Short, N. J., Dinardo, C., Daver, N., Kadia, T., Wierda, W., Wei, Y., Colla, S., Borthakur, G., Cortes, J., Estrov, Z., ... Garcia-Manero, G. (2017). Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents. American Journal of Hematology, 92(4), 351-358. https://doi.org/10.1002/ajh.24650