Systematic Literature Review of Treatment Options and Clinical Outcomes for Patients With Higher-Risk Myelodysplastic Syndromes and Chronic Myelomonocytic Leukemia

Clinical Lymphoma, Myeloma & Leukemia
Jill A BellDouglas V Faller

Abstract

High-dose chemotherapy with allogeneic hematopoietic stem cell transplantation (allo-HSCT) can produce long-term remission in patients with higher-risk myelodysplastic syndromes (HR-MDS) and chronic myelomonocytic leukemia (CMML). However, this treatment regimen is not appropriate for elderly and/or comorbid patients; in these cases, azacitidine is a standard treatment. This systematic review was conducted to evaluate real-world evidence of treatment options for patients with HR-MDS/CMML. Medline and Embase (January 2006 to May 2016) were searched, in addition to conference proceedings and treatment guideline reviews. Studies on clinical effectiveness/efficacy outcomes with a sample size ≥50 patients were included. From 1061 unique citations identified, 87 full-text articles were reviewed, of which 24 articles reported at least 1 outcome of interest. Studies showed that HR-MDS/CMML patients treated with a conventional chemotherapy regimen (CCR) have poorer overall survival (OS). Key findings from individual HR-MDS studies showed improved survival with azacitidine over CCRs and higher overall response rates with clofarabine relative to low-dose cytosine arabinoside (but no significant difference in 2-year OS favoring clofarabine...Continue Reading

Citations

Sep 13, 2019·Expert Opinion on Investigational Drugs·Georgina S Daher-ReyesKaren W L Yee
Jun 21, 2019·Therapeutic Advances in Hematology·Faris MatanesNikolaos Papadantonakis
Nov 6, 2018·Frontiers in Pharmacology·Gaia FaveroRita Rezzani
Oct 16, 2021·Future Oncology·Saaya TsutsuéBruce Crawford

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