阿扎胞苷对低危骨髓增生异常综合征及特定低危不良评分患者影响的多变量时间依赖性分析
Multivariable time-dependent analysis of the impact of azacitidine in patients with lower-risk myelodysplastic syndrome and unfavorable specific lower-risk score.
作者信息
Falantes Jose, Delgado Regina García, Calderón-Cabrera Cristina, Márquez-Malaver Francisco J, Valcarcel David, de Miguel Dunia, Bailén Alicia, Bargay Joan, Bernal Teresa, González-Porras Jose R, Tormo Mar, Ramos Fernando, Andreu Rafael, Xicoy Blanca, Nomdedeu Benet, Brunet Salut, Sánchez Joaquín, Jurado Antonio Fernández, Bonanad Santiago, Pérez-Simón Jose Antonio, Sanz Guillermo
机构信息
Hospital Universitario Virgen del Rocío, Sevilla. Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Spain.
Hospital Universitario Virgen de la Victoria, Málaga, Spain.
出版信息
Leuk Res. 2015 Jan;39(1):52-7. doi: 10.1016/j.leukres.2014.10.004. Epub 2014 Oct 30.
Scoring systems for lower-risk myelodysplastic syndrome (LR-MDS) recognize patients with a poorer than expected outcome. This study retrospectively analyzes the role of azacitidine in LR-MDS with adverse risk score and compared to an historical cohort treated with best supportive care or erythropoiesis-stimulating agents. Overall response to AZA was 40%. One and 2-year probabilities of survival were 62% and 45% for AZA vs. 25% and 11% (P=10(-4)). In a multivariable time-dependent analysis, response to AZA (CR/PR/HI) was associated with an improved survival (HR=0.234, 95% CI, 0.063-0.0863; P=0.029). Thrombocytopenia (<50 × 10(9)L(-1)) is confirmed as an adverse parameter in LR-MDS (HR=1.649, 95% CI, 1.012-2.687; P=0.045).
低危骨髓增生异常综合征（LR-MDS）评分系统可识别出预后比预期更差的患者。本研究回顾性分析了阿扎胞苷在具有不良风险评分的LR-MDS中的作用，并与接受最佳支持治疗或促红细胞生成剂治疗的历史队列进行了比较。阿扎胞苷的总体缓解率为40%。阿扎胞苷治疗组1年和2年生存率分别为62%和45%，而对照组分别为25%和11%（P = 10⁻⁴）。在多变量时间依赖性分析中，对阿扎胞苷的反应（完全缓解/部分缓解/血液学改善）与生存率提高相关（风险比=0.234，95%置信区间，0.063 - 0.0863；P = 0.029）。血小板减少症（<50×10⁹/L⁻¹）被确认为LR-MDS的不良参数（风险比=1.649，95%置信区间，1.012 - 2.687；P = 0.045）。
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