Incidence and risk of hematologic toxicities with hypomethylating agents in the treatment of myelodysplastic syndromes and acute myeloid leukopenia: A systematic review and meta-analysis

Medicine
Chong GaoJing Wang

Abstract

Hypomethylating agents (HMAs) are believed to have reliable efficacy in treating myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Meanwhile, the adverse events of HMAs have become an increasing concern. There is, however, no systematic meta-analysis available to evaluate overall hematologic toxicities for HMAs. In this meta-analysis, we aim to determine the risk of hematologic toxicities in patients treated with HMAs. Relevant studies were identified from PubMed, Embase, Cochrane Library, and the Clinical Trials. gov databases incepted to February 2018. All phase II and III trials meeting the inclusion criteria included adequate safety data. We calculated the relative risk (RR) of high-grade hematologic toxicities (HTEs) with corresponding 95% CI using Review Manager. The incidences of HTEs were also evaluated by R. Heterogeneity was calculated and reported mainly via I analyses. A total of 2337 MDS or AML patients from 14 studies were identified in this meta-analysis. The overall incidences of high-grade hematologic toxicities in patients who received HMAs were: 27% of the patients with anemia, 45% with neutropenia, 38% with thrombocytopenia, and 25% with febrile neutropenia, respectively. There was a signific...Continue Reading

References

Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Mar 1, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·P WijermansA Ferrant
May 16, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lewis R SilvermanJames F Holland
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Jan 21, 2004·Nature Reviews. Cancer·Andrew P Feinberg, Benjamin Tycko
Oct 20, 2005·Journal of the National Cancer Institute·Frank Lyko, Robert Brown
Aug 11, 2006·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Jared A GollobJean-Pierre J Issa
Aug 22, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lewis R SilvermanUNKNOWN Cancer and Leukemia Group B
Oct 6, 2006·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·David S SchrumpSeth M Steinberg
Oct 7, 2006·Critical Reviews in Oncology/hematology·Yasuhiro OkiJean-Pierre J Issa
Mar 17, 2007·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Jean-Pierre J Issa
Dec 7, 2007·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Michael GrövdalEva Hellström-Lindberg
Apr 22, 2008·International Journal of Cancer. Journal International Du Cancer·Carlo Stresemann, Frank Lyko
Mar 4, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Roger M LyonsC L Beach
Apr 23, 2009·Blood·Richard M Stone
Jun 17, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·David P SteensmaHagop Kantarjian
Jul 28, 2009·Journal of Clinical Epidemiology·David MoherUNKNOWN PRISMA Group
Aug 4, 2009·American Journal of Hematology·Mike G MartinRavi Vij
Dec 23, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Amanda F CashenJohn F DiPersio
Dec 30, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lanlan ShenJean-Pierre J Issa
Apr 7, 2010·Proceedings of the National Academy of Sciences of the United States of America·William BlumGuido Marcucci
Jun 19, 2010·Blood·Jacob M Rowe, Martin S Tallman
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
May 30, 2012·Nature Reviews. Genetics·Peter A Jones
Feb 26, 2013·British Journal of Haematology·Yun-Gyoo LeeUNKNOWN Korean Society of Haematology AML/MDS working party
Jun 5, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Guillermo Garcia-ManeroHagop Kantarjian
May 28, 2016·Haematologica·Sylvain ThépotUNKNOWN Groupe Francophone des Myélodysplasies (GFM)
Jul 20, 2017·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Na ShenShujun Liu

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Citations

Apr 4, 2020·American Journal of Hematology·Gee Youn Geeny KimAlison W Loren
Dec 4, 2019·BMJ Case Reports·Adam Morton
Dec 19, 2020·Signal Transduction and Targeted Therapy·Jenna L CarterYubin Ge
Jul 23, 2021·Experimental Biology and Medicine·Athena Starlard-DavenportBetty S Pace

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Methods Mentioned

BETA
MDS

Software Mentioned

Review Manager
R

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