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Table 1 Characteristics of trials included in the analysis

From: Targeting epigenetic pathways in acute myeloid leukemia and myelodysplastic syndrome: a systematic review of hypomethylating agents trials

Study

HMA

Median Age (Range)

FAB classificationa (%)

BM Blast (%)

Oligo-blastic AMLb (%)

WHO AML (%)

De novo AMLc (%)

Secondary AML c (%)

Type of CCR (%)

No. of Patients

Median F/U (mo)

Formula of Experimental Drug

HMA

CCR

Total

Total

Silverman 2002 [25, 30]

Azacitidine

68 (31-92)

RA: 37 (19)

RARS: 8 (4)

RAEB: 66 (35)

RAEB-T: 45 (24)

CMMoL: 14 (7)

Othersd : 21 (11)

< 30%: 170 (89)

≥ 30%: 19 (10)

45 (24)

67 (35)

0 (0)

67 (35)

BSC: 92 (100)

99

92

NR

Azacitidine: 75 mg/m2/d subcutaneous injection in 7 day cycles beginning on days 1, 29, 57, and 85.

Fenaux 2009 [31, 57]

Azacitidine

70 (38-88)

RA: 0 (0)

RARS: 0 (0)

RAEB: 207 (35)

RAEB-T: 123 (24)

CMMoL: 11 (7)

< 30%: 356 (99)

≥ 30%: 2 (1)

123 (34)

113 (32)

0 (0)

113 (32)

BSC: 105 (59)

LDAC: 49 (27)

IC: 25 (14)

179

179

21.1

Azacitidine: 75 mg/m2/d subcutaneous injection every 28 days for at least 6 cycles.

LDAC: 20 mg/m2/d subcutaneous injection for 14 d, every 28 days, at least 4 cycles.

IC: cytarabine 100-200 mg/m2/d continuous intravenous infusion for 7 days plus 3 days of either intravenous daunorubicin 40-65 mg/m2/d or idarubicin 9-12 mg/m2/d or mitoxantrone 8-12 mg/m2/d.

Lubbert 2011 [27, 28]

Decitabine

70 (60-90)

RA: 13 (6)

RARS: 5 (2)

RAEB: 125 (54)

RAEB-T: 75 (32)

CMMoL: 14 (6)

AML: 2 (1)

< 30%: 232 (99)

≥ 30%: 2 (1)

75 (32)

77 (32)

0 (0)

77 (32)

BSC: 114 (100)

119

114

30

Decitabine: 15 mg/m2 in 2 doses, intravenous infusion every 8h for 3 d. This treatment cycle was repeated every 6 wks.

Kantarjian 2012 [29]

Decitabine

73 (64-91)

RA: 0 (0)

RARS: 0 (0)

RAEB: 0 (0)

RAEB-T: 123 (25)

AML: 363 (75)

CMMoL: 0 (0)

< 30%: 123 (25)

≥ 30%: 347 (72)

123 (25)

485 (100)

312 (64)

173 (36)

BSC: 28 (12)

LDAC: 215 (88)

242

243

NR

Decitabine: 20 mg/m2/d intravenous infusion for 5 d. This treatment cycle was repeated every 4 wks.

LDAC: 20 mg/m2/d subcutaneous injection for 10 consecutive days every 4 wks.

Dombret 2014 [26, 32]

Azacitidine

75 (NR)

RA: 0 (0)

RARS: 0 (0)

RAEB: 0 (0)

RAEB-T: 0 (0)

AML: 488 (100)

< 30%: 0 (0)

≥ 30%: 488 (100)

0 (0)

488 (100)

NR e

NR e

BSC: 45 (18)

LDAC: 158 (64)

IC: 44 (18)

241

247

NR

Azacitidine: 75 mg/m2/d subcutaneous for 7 d, 28 d cycle.

LDAC: 20 mg/m2 subcutaneous injection twice a day for 10 days with every 28 days cycle.

IC: standard 7 + 3 regimen

  1. a FAB classification: RA (refractory anemia), RARS (refractory anemia with ring sideroblasts), RAEB (refractory anemia with excessive blasts), RAEB-t (RAEB in transformation with BM blast 21-30%)), CMMoL (chronic myelomonocytic leukemia), AML (acute myeloid leukemia with BM blast more thatn 30%)
  2. b Oligoblasatic AML: BM blast counts 20-30%
  3. c De novo AML: the definition of de novo and secondary AML followed the revised recommendations of the International Working Group [58] (no clinical history of MDS, MPD or exposure to potential leukemogenic treatment or agents) and followed WHO classification.
  4. d Others: AML (n = 19), undefined leukemia (n = 1), undefined MDS (n = 1)
  5. e This study included both de novo and secondary AML. Total 158 patients had AML with myelodysplastic related change (AML-MRC).
  6. Abbreviation: NR (not reported), HMA (hypomethlating agents (DNA methyl-transferase inhibitor)), BSC (best supportive care), LDAC (low dose cytarabine), IC (intensive chemotherapy)
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Clinical Epigenetics

ISSN: 1868-7083

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