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Chronic Myelomonocytic Leukemia Outcome in Argentina
Abstracts curve area analysis. The area under curve for CPSS was 0.7449 (CI 0.61168 0.87809), 0.8153 (CI 0.71336 0.91725), 0.7572 (CI .66428 0.85008) at one, two and four years respectively. Area under curve for IPSS-R was 0.7168 (CI 0.55537 0.87814), 0.6791 (CI 0.54450 0.81366), 0.7111 (IC 0.59940 0.82285) at one, two and four years respectively. Conclusions: IPSS R and CPSS risk stratification scoring systems were good predictors of survival and evolution to acute leukemia in our patients. CPSS was statistically better predictor of mortality at two years (p 0,026). There were no statistically differences in predicting evolution to acute leukemia (p 0,6).
MDS-039 Chronic Myelomonocytic Leukemia Outcome in Argentina Maria Agustina Perusini ,1 Natalia Schutz,1 Dorotea Fantl,1,2 Jorge Arbelbide1 1
Hospital Italiano Buenos Aires, Buenos Aires, Argentina; 2LAOC,
Latinamerican Oncology Consortium, CABA, Argentina
Context: CMML is a clonal disorder sharing features of myelodysplastic and myeloproliferative disorders. Data from Latin America is scarce. Objective: Describe first line treatments in clinical practice in Argentina. Evaluate responses to treatment and overall survival of our population. Design: Retrospective cohort study from June 2006 till July 2016. Setting: Study was conducted at Hospital Italiano de Buenos Aires. An integrated health care
system with 2 university hospitals, 23 outpatient centers and a Basic Science Institute. Patients or Other Participants: Adult patients with CMML confirmed diagnosis by WHO criteria were included. Main Outcomes Measures: Response to treatment was evaluated considering IWG 2006 criteria. Results were grouped for analysis in: 1) Response 2) stable disease and 3) failure. Overall survival was measured in months from date of diagnosis till death or last visit. Results: Sixty-three patients were included. Baseline characteristics in Table 1. Patients that received hypomethylating agents were 83% intermediate-2 and 33% low risk. Supportive care was provided in 63% of low and 29% of intermediate-2 risk patients (p 0.012). Erythropoietin was indicated in 73% and non-significant responses in hemoglobin value and blood transfusion dependency were seen with its use. Mean dose used was 12,000 IU per week (95% CI 8000-30000 IU). Response to hypomethylating agents was analyzed according to baseline risk. Response rate was 36%, 22% and 10% in low, intermediate-1 and intermediate-2 risk patients respectively. Treatment failure was 36%, 33% and 50% in low, intermediate-1 and intermediate-2 risk patients respectively (p ¼ 0.17). Median overall survival was 39 months (IC 95% 15 e 63). A global survival analysis and overall survival according to treatment established and CPSS risk group was performed (Table 2). Conclusions: Argentinian patients have similar characteristics to those reported in international literature. Supportive treatment was the most common treatment in low-risk patients and hypomethylating agents in high risk. There was a high failure rate with erythropoietin but may be due to the use of insufficient doses in our media. Response was directly related to basal risk established by risk stratification scales. Treatment itself did not modify statistically overall survival.
Table 1 Patients Characteristics (N 63) Median age (years)
76 (52 -90)
Gender Male N (%)
41 (65%)
Mean Corpuscular Volume Evaluation for Differential Diagnosis of Myelodysplastic Syndrome and Megaloblastic Anemia: A Study of 130 Patients
FAB category % MD
71%
MP
29%
CPSS risk % Low risk
51%
Int-1 risk
30%
Int-2 risk
19%
High risk
0%
MDS-104
Akira Yamamoto , Yui Kambara, Tomohiro Urata, Taiga Kuroi, Taro Masunari, Nobuo Sezaki, Toru Kiguchi
First Line treatment used %
Chugoku Central Hospital, Hiroshima, Japan
Supportive care
47,5%
Hypomethylating agents
47,5%
Chemeotherapy
Context: The causes of macrocytic anemia are vitamin B12 and folate deficiencies (megaloblastic anemia), medications, alcoholism,
5%
Table 2 Overall Survival According to Treatment Established and CPSS Overall Survival (months) IC 95 %() N
Global OS
Supportive care
Hypomethylants
p
Low risk
32
103 (88, 117)
103 (88- 117)
56 (6-107)
NS
Intermediate-1
19
13 (6 - 20)
13(4 - 20)
NS
Intermediate-2
12
9 (3 - 12)
9 (8-12)
NS
CPSS
S346
-
Clinical Lymphoma, Myeloma & Leukemia September 2017
17 (0-38) 8 (3 - 12)
MDS-039 Chronic Myelomonocytic Leukemia Outcome in Argentina Maria Agustina Perusini ,1 Natalia Schutz,1 Dorotea Fantl,1,2 Jorge Arbelbide1 1
Hospital Italiano Buenos Aires, Buenos Aires, Argentina; 2LAOC,
Latinamerican Oncology Consortium, CABA, Argentina
Context: CMML is a clonal disorder sharing features of myelodysplastic and myeloproliferative disorders. Data from Latin America is scarce. Objective: Describe first line treatments in clinical practice in Argentina. Evaluate responses to treatment and overall survival of our population. Design: Retrospective cohort study from June 2006 till July 2016. Setting: Study was conducted at Hospital Italiano de Buenos Aires. An integrated health care
system with 2 university hospitals, 23 outpatient centers and a Basic Science Institute. Patients or Other Participants: Adult patients with CMML confirmed diagnosis by WHO criteria were included. Main Outcomes Measures: Response to treatment was evaluated considering IWG 2006 criteria. Results were grouped for analysis in: 1) Response 2) stable disease and 3) failure. Overall survival was measured in months from date of diagnosis till death or last visit. Results: Sixty-three patients were included. Baseline characteristics in Table 1. Patients that received hypomethylating agents were 83% intermediate-2 and 33% low risk. Supportive care was provided in 63% of low and 29% of intermediate-2 risk patients (p 0.012). Erythropoietin was indicated in 73% and non-significant responses in hemoglobin value and blood transfusion dependency were seen with its use. Mean dose used was 12,000 IU per week (95% CI 8000-30000 IU). Response to hypomethylating agents was analyzed according to baseline risk. Response rate was 36%, 22% and 10% in low, intermediate-1 and intermediate-2 risk patients respectively. Treatment failure was 36%, 33% and 50% in low, intermediate-1 and intermediate-2 risk patients respectively (p ¼ 0.17). Median overall survival was 39 months (IC 95% 15 e 63). A global survival analysis and overall survival according to treatment established and CPSS risk group was performed (Table 2). Conclusions: Argentinian patients have similar characteristics to those reported in international literature. Supportive treatment was the most common treatment in low-risk patients and hypomethylating agents in high risk. There was a high failure rate with erythropoietin but may be due to the use of insufficient doses in our media. Response was directly related to basal risk established by risk stratification scales. Treatment itself did not modify statistically overall survival.
Table 1 Patients Characteristics (N 63) Median age (years)
76 (52 -90)
Gender Male N (%)
41 (65%)
Mean Corpuscular Volume Evaluation for Differential Diagnosis of Myelodysplastic Syndrome and Megaloblastic Anemia: A Study of 130 Patients
FAB category % MD
71%
MP
29%
CPSS risk % Low risk
51%
Int-1 risk
30%
Int-2 risk
19%
High risk
0%
MDS-104
Akira Yamamoto , Yui Kambara, Tomohiro Urata, Taiga Kuroi, Taro Masunari, Nobuo Sezaki, Toru Kiguchi
First Line treatment used %
Chugoku Central Hospital, Hiroshima, Japan
Supportive care
47,5%
Hypomethylating agents
47,5%
Chemeotherapy
Context: The causes of macrocytic anemia are vitamin B12 and folate deficiencies (megaloblastic anemia), medications, alcoholism,
5%
Table 2 Overall Survival According to Treatment Established and CPSS Overall Survival (months) IC 95 %() N
Global OS
Supportive care
Hypomethylants
p
Low risk
32
103 (88, 117)
103 (88- 117)
56 (6-107)
NS
Intermediate-1
19
13 (6 - 20)
13(4 - 20)
NS
Intermediate-2
12
9 (3 - 12)
9 (8-12)
NS
CPSS
S346
-
Clinical Lymphoma, Myeloma & Leukemia September 2017
17 (0-38) 8 (3 - 12)