Higher-Risk MDS Patients May Achieve Similar Survival With Stem Cell Transplant Or Treatment With Vidaza Or Dacogen (ASH 2011)
Published: Mar 1, 2012 10:44 am
Results of a retrospective analysis indicate that stem cell transplantation does not significantly improve survival for higher-risk myelodysplastic syndromes patients compared to treatment with Vidaza or Dacogen.
As a result, the researchers who conducted the analysis conclude that treatment with Vidaza (azacitidine) or Dacogen (decitabine) is an “adequate alternative” for myelodysplastic syndromes (MDS) patients ineligible for stem cell transplantation. They also recommend that transplant-eligible patients be treated with Vidaza or Dacogen while waiting for a stem cell donor.
The findings were presented at the 2011 meeting of the American Society of Hematology (ASH) in December.
Stem cell transplantation, in which the patient’s unhealthy bone marrow stem cells are replaced with healthy ones from a donor, is the only potential cure for MDS. However, few MDS patients are eligible for transplantation due to their age or the presence of other health problems.
Instead, MDS patients are often treated with Vidaza or Dacogen.
In order to evaluate the outcomes after stem cell transplantation compared to treatment with Vidaza or Dacogen without transplantation, the researchers retrospectively analyzed data from 93 higher-risk MDS patients who received a stem cell transplant (53 patients) or treatment with Vidaza or Dacogen (40 patients) at the M.D. Anderson Cancer Center between January 1988 and April 2008.
The researchers only included patients in the analysis who had not received any MDS treatment prior to stem cell transplantation.
Among the patients who were treated at their center with Vidaza or Dacogen, the researchers selected patients to match those who received stem cell transplants. The matching criteria were the following: age, year of diagnosis, percentage of immature bone marrow cells at diagnosis, risk of disease progression, and time from diagnosis to treatment. Patients had to match on at least three of the criteria.
Patients who received treatment with Vidaza or Dacogen were slightly older (median age 54 years) than those who received a stem cell transplant (median age 51 years).
The median follow-up time was 64 months.
Of the patients who received treatment with Vidaza and Dacogen and who were evaluable for analysis, 61 percent responded to treatment, including 52 percent who achieved a complete response. The researchers did not report response rates for the patients who received stem cell transplants.
The median overall survival time for patients receiving a stem cell transplant was 26 months, compared to 25 months for patients treated with Vidaza or Dacogen.
The overall survival rate after eight years was 24 percent for patients who received stem cell transplants and 23 percent for patients who received treatment with Vidaza or Dacogen.
- Vidaza Or Dacogen Treatment May Be Effective In MDS Patients Before Stem Cell Transplantation (EHA 2010)
- Vidaza And Dacogen Therapy Before Stem Cell Transplantation Is Effective And Safe In MDS Patients
- Response To Dacogen Or Vidaza Prior To Transplant May Affect Transplant Outcomes In MDS Patients
- Vidaza Treatment Before Stem Cell Transplant Is Feasible In MDS (ASCO 2012)
- Dacogen And Vidaza May Improve Survival Of MDS Patients With Monosomy 7 (EHA 2012)