TY - JOUR
T1 - Expanding on Current Definitions of Hematologic Improvement in MDS, CMML and AML: Landmark Analyses of 1301 Patients Treated with Azacitidine in the Austrian Registry of Hypomethylating Agents By the AGMT-Study Group
T2 - American Society of Hematology, 61th Annual Meeting, scientific session
AU - Pleyer, Lisa
AU - Pfeilstocker, Michael
AU - Stauder, Reinhard
AU - Heibl, Sonja
AU - Sill, Heinz
AU - Girschikofsky, Michael
AU - Stampfl-Mattersberger, Margarete
AU - Tinchon, Christoph
AU - Petzer, Andreas
AU - Schmitt, Clemens A.
AU - Vallet, Sonia
AU - Mandac, Inga
AU - Geissler, Klaus
AU - Sperr, Wolfgang R.
AU - Leisch, Michael
AU - Egle, Alexander
AU - Melchardt, Thomas
AU - Fusinato, Julia
AU - Piringer, Gudrun
AU - Zebisch, Armin
AU - Machherndl-Spandl, Sigrid
AU - Wolf, Dominik
AU - Keil, Felix
AU - Greil, Richard
PY - 2019
Y1 - 2019
N2 - Background In myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML) and acute myeloid leukemia (AML), achievement of morphologic complete response (CR) is a prerequisite for potential cure. In AML, CR is deemed the major outcome associated with improved overall survival (OS); patients (pts) without CR are considered non-responders, and hematologic improvement (HI) without bone marrow blast (BMB) clearance is considered treatment (trt) failure (Cheson 2003). Evidence suggests that these definitions may not be applicable to older pts treated with hypomethylating agents (HMA), and that achievement of CR may not be necessary for prolonged OS (Pleyer 2013, 2014, 2015; Schuh 2015; Bloomfield 2018).IWG response criteria for HI do not differentiate between pts who qualify for response (QFR) vs those that do not. Pts with 'normal' blood counts at trt start are per definition HI non-responders. This may obscure potential survival benefits of responding pts.Aims 1) Assess the impact of HI irrespective of BMB clearance and excluding immortal time bias via landmark analyses. 2) Differentiate between pts who QFR, and those with 'normal' baseline values (not-QFR) defined according to IWG prerequisites for CR. 3) Introduce 3 new categories of HI: peripheral blood blasts (PBB), elevated white blood cells (WBC), and PB-CR (defined as Hb ≥11 g/dl, ANC ≥1.0 G/l, WBC
AB - Background In myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML) and acute myeloid leukemia (AML), achievement of morphologic complete response (CR) is a prerequisite for potential cure. In AML, CR is deemed the major outcome associated with improved overall survival (OS); patients (pts) without CR are considered non-responders, and hematologic improvement (HI) without bone marrow blast (BMB) clearance is considered treatment (trt) failure (Cheson 2003). Evidence suggests that these definitions may not be applicable to older pts treated with hypomethylating agents (HMA), and that achievement of CR may not be necessary for prolonged OS (Pleyer 2013, 2014, 2015; Schuh 2015; Bloomfield 2018).IWG response criteria for HI do not differentiate between pts who qualify for response (QFR) vs those that do not. Pts with 'normal' blood counts at trt start are per definition HI non-responders. This may obscure potential survival benefits of responding pts.Aims 1) Assess the impact of HI irrespective of BMB clearance and excluding immortal time bias via landmark analyses. 2) Differentiate between pts who QFR, and those with 'normal' baseline values (not-QFR) defined according to IWG prerequisites for CR. 3) Introduce 3 new categories of HI: peripheral blood blasts (PBB), elevated white blood cells (WBC), and PB-CR (defined as Hb ≥11 g/dl, ANC ≥1.0 G/l, WBC
U2 - 10.1182/blood-2019-128153
DO - 10.1182/blood-2019-128153
M3 - Conference contribution to journal
SN - 0006-4971
VL - 134
SP - 3821
JO - Blood
JF - Blood
IS - Supplement_1
ER -