5-AZA effective for myelodysplastic syndromes in elderly adults

In elderly adults with intermediate- or high-risk myelodysplastic syndromes (MDS) or oligoblastic acute myeloid leukaemia (AML), 5-azacytidine (5-AZA) may be an effective treatment option, a recent study has found.

Researchers conducted a retrospective analysis of 102 elderly adults (median age, 83 years) who had intermediate-2 or high-risk MDS. Frontline treatment was carried out with a single dose of 75 mg/m²/day of 5-AZA, given for seven consecutive days. The study outcomes were treatment response, overall survival and time to transformation to AML.

The overall response rate was 44.3 percent, with a median response duration of 12 months. Sixty-three participants had available data for 5-AZA relative dose intensity (RDI); of these, 81.0 percent (n=63) were able to take the standard dose. Almost half (24 of 52; 46.2 percent) of patients who were dependent at baseline achieved transfusion independence.

Over a median follow-up of 17 months, the median AML-free survival time was estimated to be 49 months. This turned out to be longer in participants who had responded to the treatment (failure vs overall response: hazard ratio [HR], 7.56, 95 percent confidence interval [CI], 2.61–21.95; p<0.001). 5-AZA RDI did not significantly affect AML-free survival (p=0.51).

On the other hand, the medial overall survival estimate was 17 months, similarly greater in those who responded to 5-AZA treatment (failure vs overall response: HR, 6.00, 95 percent CI, 3.07–11.70; p<0.001). RDI was not significantly predictive of overall survival.