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01.03.2012 | Original Article | Ausgabe 3/2012

Annals of Hematology 3/2012

Pilot study on combination of azacitidine and low-dose cytarabine for patients with refractory anemia with excess blast

Zeitschrift:
Annals of Hematology > Ausgabe 3/2012
Autoren:
Joon Ho Moon, Soo Jung Lee, Yoo Jin Lee, Byung Woog Kang, Yee Soo Chae, Jong Gwang Kim, Jang Soo Suh, Sang Kyun Sohn

Abstract

This study analyzed the outcomes of the combination of azacitidine and low-dose cytarabine in patients newly diagnosed with refractory anemia with excess blast (RAEB). Patients were treated with azacitidine 75 mg/m2 for 7 days subcutaneously and cytarabine 20 mg/m2 intravenously for 7 days every 28 days. The assigned regimen was repeated for two cycles, then the patients treated with azacytidine alone until progression or allogeneic stem cell transplantation (allo-SCT). Eighteen patients with 5 RAEB-1 and 13 RAEB-2 were enrolled in the current study. After two cycles of the combination therapy, responses were achieved in nine patients (50.0%): four complete response (CR) (22.2%), one partial response (5.6%), two marrow-CR (11.1%), and two hematologic improvement (11.1%). Four patients (22.2%) progressed to acute leukemia during two cycles of the combination therapy. The 1-year overall survival (OS) was 87.5% for the early response group (responses at two cycles) and 0% for the late response group (responses at four cycles, p = 0.042). Plus, the median survival time was 476 days (range, 37–718 days) for the early response group and 221 days (range, 193–249 days) for the late response group. The 1-year OS was 100% for the patients who underwent allo-SCT and 73.4% for those without allo-SCT. In summary, the combination therapy showed promising response rate when compared to treatment with azacitidine alone. However, it was limited in terms of preventing leukemic transformation. Allo-SCT would seem to be the only available treatment that can alter disease progression.

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