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

Research output: Contribution to journalArticle

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
Externally publishedYes

Fingerprint

Myelodysplastic Syndromes
Cytogenetics
Survival
Abnormal Karyotype
Leukemia
Multivariate Analysis

ASJC Scopus subject areas

  • Hematology

Cite this

Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents. / Jabbour, Elias; Strati, Paolo; Cabrero, Monica; O'Brien, Susan; Ravandi, Farhad; Bueso-Ramos, Carlos; Wei, Qiao; Hu, Jianhua; Abi Aad, Simon; Short, Nicholas J.; Dinardo, Courtney; Daver, Naval; Kadia, Tapan; Wierda, William; Wei, Yue; Colla, Simona; Borthakur, Gautam; Cortes, Jorge; Estrov, Zeev; Kantarjian, Hagop; Garcia-Manero, Guillermo.

In: American Journal of Hematology, Vol. 92, No. 4, 01.04.2017, p. 351-358.

Research output: Contribution to journalArticle

Jabbour, E, Strati, P, Cabrero, M, O'Brien, S, Ravandi, F, Bueso-Ramos, C, Wei, Q, Hu, J, Abi Aad, S, Short, NJ, Dinardo, C, Daver, N, Kadia, T, Wierda, W, Wei, Y, Colla, S, Borthakur, G, Cortes, J, Estrov, Z, Kantarjian, H & 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, vol. 92, no. 4, pp. 351-358. https://doi.org/10.1002/ajh.24650
Jabbour, Elias ; Strati, Paolo ; Cabrero, Monica ; O'Brien, Susan ; Ravandi, Farhad ; Bueso-Ramos, Carlos ; Wei, Qiao ; Hu, Jianhua ; Abi Aad, Simon ; Short, Nicholas J. ; Dinardo, Courtney ; Daver, Naval ; Kadia, Tapan ; Wierda, William ; Wei, Yue ; Colla, Simona ; Borthakur, Gautam ; Cortes, Jorge ; Estrov, Zeev ; Kantarjian, Hagop ; Garcia-Manero, Guillermo. / Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents. In: American Journal of Hematology. 2017 ; Vol. 92, No. 4. pp. 351-358.
@article{bdd43e69aac84f0b8c26b72fa85664c8,
title = "Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents",
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.",
author = "Elias Jabbour and Paolo Strati and Monica Cabrero and Susan O'Brien and Farhad Ravandi and Carlos Bueso-Ramos and Qiao Wei and Jianhua Hu and {Abi Aad}, Simon and Short, {Nicholas J.} and Courtney Dinardo and Naval Daver and Tapan Kadia and William Wierda and Yue Wei and Simona Colla and Gautam Borthakur and Jorge Cortes and Zeev Estrov and Hagop Kantarjian and Guillermo Garcia-Manero",
year = "2017",
month = "4",
day = "1",
doi = "10.1002/ajh.24650",
language = "English (US)",
volume = "92",
pages = "351--358",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents

AU - Jabbour, Elias

AU - Strati, Paolo

AU - Cabrero, Monica

AU - O'Brien, Susan

AU - Ravandi, Farhad

AU - Bueso-Ramos, Carlos

AU - Wei, Qiao

AU - Hu, Jianhua

AU - Abi Aad, Simon

AU - Short, Nicholas J.

AU - Dinardo, Courtney

AU - Daver, Naval

AU - Kadia, Tapan

AU - Wierda, William

AU - Wei, Yue

AU - Colla, Simona

AU - Borthakur, Gautam

AU - Cortes, Jorge

AU - Estrov, Zeev

AU - Kantarjian, Hagop

AU - Garcia-Manero, Guillermo

PY - 2017/4/1

Y1 - 2017/4/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85013001650&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013001650&partnerID=8YFLogxK

U2 - 10.1002/ajh.24650

DO - 10.1002/ajh.24650

M3 - Article

C2 - 28076892

AN - SCOPUS:85013001650

VL - 92

SP - 351

EP - 358

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 4

ER -