Chronic myelomonocytic leukemia treated with 5-azacytidine – results from the Hellenic 5-Azacytidine Registry: proposal of a new risk stratification system

Diamantopoulos, Panagiotis; Kotsianidis, Ιoannis; Symeonidis, Argiris; Pappa, Vassiliki; Galanopoulos, Athanasios; Gogos, Dimitrios; Karakatsanis, Stamatis; Papadaki, Helen Α.; Palla, Aikaterini; Hatzimichael, Eleftheria; Dimou, Maria; Papageorgiou, Sotirios G.; Delimpasis, Sosana; Papaioannou, Maria; Papoutselis, Menelaos; Kourakli, Alexandra; Tsokanas, Dimitrios; Anagnostopoulos, Achilles; Kontos, Christos K.; Panayiotidis, Panayiotis; Viniou, Nora‐Athina

doi:10.1080/10428194.2018.1540783

Cited by 13 publications

(16 citation statements)

References 26 publications

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“…23 Moreover, our group recently identified the adverse prognostic value of the high SF levels in patients with chronic myelomonocytic leukemia. 24 Of note, ferritin cutoff levels have been inconsistent throughout these studies. Even though retrospective in nature, our trial is the largest to date to explore the effects of SF levels in patients with HR-MDS and oligoblastic AML treated with 5-AZA.…”

Section: Discussionmentioning

confidence: 99%

Serum ferritin and ECOG performance status predict the response and improve the prognostic value of IPSS or IPSS-R in patients with high-risk myelodysplastic syndromes and oligoblastic acute myeloid leukemia treated with 5-azacytidine: a retrospective analysis of the Hellenic national registry of myelodysplastic and hypoplastic syndromes

Papageorgiou

Kotsianidis

Symeonidis

et al. 2020

Therapeutic Advances in Hematology

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Background: 5-azacytidine (5-AZA) improves survival of patients with higher-risk myelodysplastic syndromes (MDSs) and oligoblastic acute myeloid leukemia (AML); however, predictive factors for response and outcome have not been consistently studied. Methods: This study of the Hellenic MDS Study Group included 687 consecutive patients with higher-risk MDS and oligoblastic AML treated with 5-AZA. Results: The International Prognostic Scoring System (IPSS) revised version (IPSS-R), Eastern Cooperative Oncology Group Performance Status (ECOG PS) (0 or 1 versus ⩾2) and baseline serum ferritin (SF) levels > 520 ng/ml were shown to independently predict response to 5-AZA. In the survival analysis, the IPSS and IPSS-R risk classification systems along with the ECOG PS and SF levels > 520 ng/ml proved to be independent prognosticators for overall survival (OS), as well as for leukemia-free survival (LFS). Next, we built new multivariate models for OS and LFS, incorporating only ECOG PS and SF levels besides IPSS or IPSS-R risk classification systems. Thereby, the new modified IPSS and IPSS-R risk classification systems (H-PSS, H-PSS-R) could each discriminate a low, an intermediate and a high-risk patient group regarding OS and LFS. The H-PSS and H-PSS-R proved to be better predictors of OS than their previous counterparts as well as the French prognostic score, while the most powerful OS predictor was the new, H-PSS-R system. Conclusions: ECOG PS and SF levels > 520 ng/ml independently predict response to 5-AZA, OS and LFS. Their incorporation in the IPSS and IPSS-R scores enhances these scores’ predictive power in 5-AZA-treated higher-risk MDS and oligoblastic AML patients.

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Section: Discussionmentioning

confidence: 99%

Serum ferritin and ECOG performance status predict the response and improve the prognostic value of IPSS or IPSS-R in patients with high-risk myelodysplastic syndromes and oligoblastic acute myeloid leukemia treated with 5-azacytidine: a retrospective analysis of the Hellenic national registry of myelodysplastic and hypoplastic syndromes

Papageorgiou

Kotsianidis

Symeonidis

et al. 2020

Therapeutic Advances in Hematology

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“…They have been discussed at length elsewhere [331]. Recently, these molecules have also been targeted for cancer therapy [314,332].…”

Section: Discussionmentioning

confidence: 99%

Transcription Factors That Govern Development and Disease: An Achilles Heel in Cancer

Huilgol

Venkataramani

Nandi

et al. 2019

Genes

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Development requires the careful orchestration of several biological events in order to create any structure and, eventually, to build an entire organism. On the other hand, the fate transformation of terminally differentiated cells is a consequence of erroneous development, and ultimately leads to cancer. In this review, we elaborate how development and cancer share several biological processes, including molecular controls. Transcription factors (TF) are at the helm of both these processes, among many others, and are evolutionarily conserved, ranging from yeast to humans. Here, we discuss four families of TFs that play a pivotal role and have been studied extensively in both embryonic development and cancer—high mobility group box (HMG), GATA, paired box (PAX) and basic helix-loop-helix (bHLH) in the context of their role in development, cancer, and their conservation across several species. Finally, we review TFs as possible therapeutic targets for cancer and reflect on the importance of natural resistance against cancer in certain organisms, yielding knowledge regarding TF function and cancer biology.

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“…Some of these drugs, such as the hypomethylating agents (5-azacytidine, decitabine) may induce long-term disease control in a subset of patients with classical CMML. 139-145 In general, cytoreductive and palliative drugs should be used according to available recommendations provided by major societies. 145,148 Similarly, treatment response assessment should be performed in line with available (accepted) guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…139-145 In general, cytoreductive and palliative drugs should be used according to available recommendations provided by major societies. 145,148 Similarly, treatment response assessment should be performed in line with available (accepted) guidelines. 146,150…”

Section: Introductionmentioning

confidence: 99%

Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions

et al. 2019

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Chronic myelomonocytic leukemia (CMML) is a myeloid neoplasm characterized by dysplasia, abnormal production and accumulation of monocytic cells and an elevated risk of transforming into acute leukemia. Over the past two decades, our knowledge about the pathogenesis and molecular mechanisms in CMML has increased substantially. In parallel, better diagnostic criteria and therapeutic strategies have been developed. However, many questions remain regarding prognostication and optimal therapy. In addition, there is a need to define potential pre-phases of CMML and special CMML variants, and to separate these entities from each other and from conditions mimicking CMML. To address these unmet needs, an international consensus group met in a Working Conference in August 2018 and discussed open questions and issues around CMML, its variants, and pre-CMML conditions. The outcomes of this meeting are summarized herein and include diag nostic criteria and a proposed classification of pre-CMML conditions as well as refined minimal diagnostic criteria for classical CMML and special CMML variants, including oligomonocytic CMML and CMML associated with systemic mastocytosis. Moreover, we propose diagnostic standards and tools to distinguish between ‘normal’, pre-CMML and CMML entities. These criteria and standards should facilitate diagnostic and prognostic evaluations in daily practice and clinical studies in applied hematology.

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Chronic myelomonocytic leukemia treated with 5-azacytidine – results from the Hellenic 5-Azacytidine Registry: proposal of a new risk stratification system

Cited by 13 publications

References 26 publications

Transcription Factors That Govern Development and Disease: An Achilles Heel in Cancer

Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions

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