Response to erythropoietic-stimulating agents in patients with chronic myelomonocytic leukemia

European Journal of Haematology
Blanca XicoyGuillermo F Sanz

Abstract

The efficacy of erythropoietic-stimulating agents (ESA) in chronic myelomonocytic leukemia (CMML) is unknown. Our objective was to analyze erythroid response (ER) and overall survival (OS) in a series of 94 patients with CMML treated with ESA. We analyzed a series of 94 patients with CMML treated with ESA included in the Spanish and Düsseldorf-MDS registries. ER was observed in 64% of patients and red blood cell (RBC) transfusion independence in 31%. The median duration of ER was 7 months (range, 0-88). CPSS and EPO level were significantly associated with ER in multivariate analysis (P = 0.003). Considering only patients with CPSS low- or intermediate-1-risk group, the absence of RBC transfusion dependence and erythropoietin (EPO) level predicted ER (P = 0.003 and P = 0.008, respectively). In multivariate analysis, only the EPO level retained its prognostic value (P = 0.029). Achievement of ER correlated with a better survival since ER evaluation (P = 0.016). The CPSS and EPO levels are adequate tools to select CMML patients with symptomatic anemia who may benefit from treatment with ESA. A significant ER to ESA is expected in anemic patients with low/intermediate-1 CMML risk by the CPSS and a low endogenous serum EPO level.

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Citations

Jun 3, 2017·Blood·Eric Solary, Raphael Itzykson
Sep 1, 2018·Current Opinion in Oncology·Elvira Mora, Guillermo F Sanz
Jul 30, 2019·Expert Review of Hematology·Ulrich GermingNorbert Gattermann
Jul 24, 2020·Expert Review of Anticancer Therapy·Jennifer KaiversUlrich Germing
Nov 17, 2016·Current Opinion in Oncology·Ana AlfonsoGuillermo Garcia-Manero
Apr 30, 2017·International Journal of Hematology·Raphael ItzyksonEric Solary
Nov 16, 2019·Current Oncology Reports·Giacomo Coltro, Mrinal M Patnaik
Dec 8, 2020·Expert Opinion on Emerging Drugs·Jorge Ramos Perez, Guillermo Montalban-Bravo
Dec 5, 2020·Expert Review of Hematology·Thomas P ThomopoulosVasiliki Pappa
Mar 15, 2021·Leukemia·Onyee ChanEric Padron
Apr 2, 2021·The Oncologist·Douglas TremblayJohn Mascarenhas
May 4, 2021·Blood Research·Jihyun Kwon
Dec 3, 2021·Current Opinion in Hematology·Abhishek Dhawan, Eric Padron

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