TY - JOUR
T1 - A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia
AU - Santini, V.
AU - Allione, B.
AU - Zini, G.
AU - Gioia, D.
AU - Lunghi, M.
AU - Poloni, A.
AU - Cilloni, D.
AU - Sanna, A.
AU - Masiera, E.
AU - Ceccarelli, M.
AU - Abdel-Wahab, O.
AU - Terenzi, A.
AU - Angelucci, E.
AU - Finelli, C.
AU - Onida, F.
AU - Pelizzari, A.
AU - Ferrero, D.
AU - Saglio, G.
AU - Figueroa, M.
AU - Levis, A.
N1 - Funding Information:
This study was funded by the Fondazione Italiana Sindromi Mielodisplastiche Onlus (FISMOnlus). Under direction of the authors, medical writing services for early versions of the manuscript were provided by Dr Joanna Todd of Rocket Science Medical Communications Limited, UK. Medical writing services were funded by the FISMonlus.
Publisher Copyright:
© The Author(s) 2018.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2 per day on Days 1-5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4-57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
AB - Chronic myelomonocytic leukemia (CMML) is a complex clonal hematological disorder classified among myelodysplastic (MDS)/myeloproliferative neoplasms. Prognosis is poor and there is a lack of effective treatments. The hypomethylating agent decitabine has shown activity against MDS and elderly acute myeloid leukemia, but there is little data focusing specifically on its efficacy in CMML. In this prospective, phase 2 Italian study, CMML patients received intravenous decitabine 20 mg/m2 per day on Days 1-5 of a 28-day treatment cycle. Response was evaluated after four and six cycles; patients responding at the end of six cycles could continue treatment with decitabine. Forty-three patients were enrolled; >50% were high-risk according to four CMML-specific scoring systems. In the intent-to-treat population (n=42), the overall response rate after six cycles was 47.6%, with seven complete responses (16.6%), eight marrow responses (19%), one partial response (2.4%) and four hematological improvements (9.5%). After a median follow-up of 51.5 months (range: 44.4-57.2), median overall survival was 17 months, with responders having a significantly longer survival than non-responders (P=0.02). Grade 3/4 anemia, neutropenia and thrombocytopenia occurred in 28.6%, 50% and 38% of patients, respectively. Decitabine appears to be an effective and well-tolerated treatment for patients with high-risk CMML.
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U2 - 10.1038/leu.2017.186
DO - 10.1038/leu.2017.186
M3 - Article
C2 - 28607470
AN - SCOPUS:85042282816
VL - 32
SP - 413
EP - 418
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - 2
ER -