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Comparative analysis between azacitidine and decitabine for the treatment of myelodysplastic syndromes
Author(s) -
Lee YunGyoo,
Kim Inho,
Yoon SungSoo,
Park Seonyang,
Cheong June Won,
Min Yoo Hong,
Lee JeongOk,
Bang SooMee,
Yi Hyeon Gyu,
Kim Chul Soo,
Park Yong,
Kim ByungSoo,
Mun YeungChul,
Seong ChuMyoung,
Park Jinny,
Lee Jae Hoon,
Kim SungYong,
Lee Hong Ghi,
Kim YeoKyeoung,
Kim HyeoungJoon
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12256
Subject(s) - azacitidine , decitabine , medicine , myelodysplastic syndromes , propensity score matching , homoharringtonine , adverse effect , oncology , international prognostic scoring system , leukemia , bone marrow , dna methylation , biology , biochemistry , gene expression , gene
Summary The present study aimed to directly compare the efficacy and safety of azacitidine and decitabine in patients with myelodysplastic syndromes ( MDS ). We compared the overall response rate ( ORR ) (complete responses, partial responses, marrow complete responses, and haematological improvements), overall survival ( OS ), event‐free survival ( EFS ), time to leukaemic transformation, and adverse outcomes between azacitidine and decitabine. To minimize the effects of treatment selection bias in this observational study, adjustments were made using the propensity‐score matching method. Among 300 patients, 203 were treated with azacitidine and 97 with decitabine. Propensity‐score matching yielded 97 patient pairs. In the propensity‐matched cohort, there were no significant differences between the azacitidine and decitabine groups regarding ORR (44% vs. 52%), OS (26 vs. 22·9 months), EFS (7·7 vs. 7·0 months), and rate of leukaemic transformation (16% vs. 22% at 1 year). In patients ≥65 years of age, survival was significantly better in the azacitidine group ( P = 0·017). Patients who received decitabine experienced more frequent episodes of grade 3 or 4 cytopenia and infectious episodes. We found that azacitidine and decitabine showed comparable efficacy. Among patients ≥65 years of age, survival was significantly better in the azacitidine group (ClinicalTrials.gov Identifier: NCT01409070).