Abstract
Abstract 4285
Acute erythroleukemia (AEL) is usually characterized by cytopenias with myelodysplastic features and is frequently associated with unfavourable karyotype. AEL is associated with a poor prognosis. There is no specific therapy for AEL and results of standard induction chemotherapy have been unsatisfactory. Hypomethylating agents have been used with success in myelodysplastic syndromes (MDS) with improved overall survival (OS) of MDS patients treated with azacitidine compared to those receiving conventional care regimens in the AZA001 phase III trial. Efficacy of hypomethylating agents has also been demonstrated in small groups of AEL patients, advocating a role for these agents alone, or in combination, as first line therapy. We report 3 patients diagnosed with AEL at a single institution treated with azacitidine 500 mg/m2 every 4 weeks divided in 5 days per cycle. All cases were diagnosed according to the 2008 WHO criteria and response criteria were based on the revised recommendation of the International Working Group published in 2003.
Patients demographic characteristics.
| Patient . | Agea (in years) . | Sex . | Co-morbidities . |
|---|---|---|---|
| 1 | 62 | M | ObesityBenign prostatic hyperplasia |
| 2 | 65 | M | None |
| 3 | 76 | M | Diabetes |
| Patient . | Agea (in years) . | Sex . | Co-morbidities . |
|---|---|---|---|
| 1 | 62 | M | ObesityBenign prostatic hyperplasia |
| 2 | 65 | M | None |
| 3 | 76 | M | Diabetes |
Patients hematological characteristics at baseline.
| Patient . | Hemoglobin(g/dL) . | WBC(x109/L)/ANC . | Platelets (x109/L) . | Cytogenetic . |
|---|---|---|---|---|
| 1 | 8.0 | 1.700/0.470 | 60000 | del(5)(q15q?(31) |
| 2 | 7.7 | 10.300/1.300 | 367000 | Normal karyotype |
| 3 | 6.8 | 1.000/0.180 | 124000 | 45, XY, -7, del(20)(q11q13) |
| Patient . | Hemoglobin(g/dL) . | WBC(x109/L)/ANC . | Platelets (x109/L) . | Cytogenetic . |
|---|---|---|---|---|
| 1 | 8.0 | 1.700/0.470 | 60000 | del(5)(q15q?(31) |
| 2 | 7.7 | 10.300/1.300 | 367000 | Normal karyotype |
| 3 | 6.8 | 1.000/0.180 | 124000 | 45, XY, -7, del(20)(q11q13) |
Treatment characteristics and response.
| Patient . | Previous treatments . | Treatment duration . | Time to transfusion independency . | Best Hematological response . | Time to response . |
|---|---|---|---|---|---|
| 1 | Conventional chemotherapy | 13 cycles | 4 cycles | Complete remission (no cytogenetic remission) | 6 cycles |
| 2 | None | 17 cycles | 5 cycles | Complete remission | 10 cycles |
| 3 | None | 9 cycles | 4 cycles | Hematological improvement | 4 cycles |
| Patient . | Previous treatments . | Treatment duration . | Time to transfusion independency . | Best Hematological response . | Time to response . |
|---|---|---|---|---|---|
| 1 | Conventional chemotherapy | 13 cycles | 4 cycles | Complete remission (no cytogenetic remission) | 6 cycles |
| 2 | None | 17 cycles | 5 cycles | Complete remission | 10 cycles |
| 3 | None | 9 cycles | 4 cycles | Hematological improvement | 4 cycles |
Therapy was well tolerated and all patients achieved transfusion independency with improvement in quality of life. At 12 months follow-up, all of them are alive, two patients are in complete sustained remission, one of whom awaits stem cell transplantation, while one patient is currently on supportive care.
These results confirm the active role of azacitidine in AEL.
Almeida:Celgene: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; BMS: Speakers Bureau.
Author notes
Asterisk with author names denotes non-ASH members.
