Platelet Doubling After First Decitabine Cycle Predicts Response and Survival of Myelodysplastic Syndrome Patients

Lu, Pingfan; Deng, Linan; Fang, Meng; Wang, Ying; Xiao, Min; Li, Dengju

doi:10.1007/s11596-022-2533-4

Cited by 1 publication

(3 citation statements)

References 30 publications

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“…Our study demonstrated that the number of transfusions representing platelet changes was related to prognosis, which validates these previous findings. Unlike previous studies that predicted a favorable prognosis in patients whose platelet counts increased after starting HMA (19,20) or predicted the response rate based on blood cell changes after starting HMA (21), our study has a notable strength in identifying patients with a very inferior prognosis as evidenced by the median survival of approximately four months in the poor-risk group according to KCSS, which was not included in previous studies.…”

Section: Discussionmentioning

confidence: 90%

“…In previous studies, hematologic recovery after starting HMA in MDS patients has been reported to be associated with treatment outcomes. Lieke et al and Ping et al showed that platelet count changes after HMA initiation correlate with prognosis ( 19 , 20 ). Nathan et al created a machine learning model to predict favorable treatment responses in 424 MDS patients treated with AZA for over four months.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, AZA treatment potentially causes various types of adverse events that hamper treatment continuation (10,(16)(17), and, especially, hematologic toxicities frequently necessitate the increase of blood transfusion, trigger severe infection, and even result in the treatment cessation in the early phase of treatment (18). Although several previous studies have reported the influence of blood cell transition after the initiation of hypomethylating agents (HMA) on response and prognosis in patients with MDS (19)(20)(21), the prognostic impact of hematologic toxicities in the early clinical phase of AZA monotherapy has not been evaluated in conjunction with pre-treatment prognostic factors commonly utilized in the classical prognostic indices, such as IPSS-R.…”

Section: Introductionmentioning

confidence: 99%

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Clinical impacts of severe thrombocytopenia in the first cycle of azacitidine monotherapy and cytogenetics in patients with myelodysplastic syndrome: The Kyoto Conditional Survival Scoring System

Inoue,

Okamoto,

Miyashita

et al. 2023

Oncol Lett

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Azacitidine (AZA) has been one of the standard treatments for transplantation-ineligible patients with myelodysplastic syndrome (MDS); however, hematological toxicities frequently cause treatment interruption in the early phase of the therapy. The present study conducted a multicenter retrospective study to investigate the prognostic impacts of various factors, including factors included in the Revised International Prognostic Scoring System (IPSS-R) and severe cytopenia in the early phase of AZA monotherapy in 212 patients with MDS. Severe cytopenia was evaluated after the initiation of therapy by absolute neutrophil counts on the 29th day after AZA (ANC29) initiation, and red cell concentrates (RCC) and platelet concentrate (PC) transfusion units required within 28 days from the start of AZA, designated in the present study as RCC28 and PC28, respectively. The survival period was determined from the 29th day of AZA treatment to death from any cause as the conditional survival period after the first cycle of AZA (CS-AZA1). Multivariate analysis demonstrated that severe thrombocytopenia defined by >30 units of PC28 and very poor risk cytogenetics according to IPSS-R were independent prognostic factors for CS-AZA1. The Kyoto Conditional Survival Scoring System was subsequently developed by incorporating severe thrombocytopenia defined by PC28 and very poor risk cytogenetics, which successfully stratified the risks of the patients in CS-AZA1. In conclusion, extreme PC transfusion dependency during the first cycle of AZA and very poor risk cytogenetics are important prognostic factors in AZA monotherapy for MDS.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%