Predictive factors of overall survival and treatment response in high-risk older patients with MDS and CMML under hypomethilating agents. Latin-American MDS Group ? GLAM

GRILLÉ, SOFÍA; FLORES, GABRIELA; PIMENTEL, MAYRA; RAMIREZ, JOHANA; ARAUJO SCHUSTER, SERGIO; HUAMAN-GARAICOA, FUAD; IASTREBNER, MARCELO; DISTÉFANO, MARCOS; FERNANDEZ, ISOLDA; NUCIFORA, ELSA; TAVAREZ, R; ABELLO POLO, VIRGINIA; BELLI, CAROLINA; LAZZARINO, CAROLINA; ENRICO, ALICIA; ALFONSO, GRACIELA; OVILLA, ROBERTO; SARMIENTO, MARCELA; SERRANO, JUAN CARLOS

Estocolmo

Congreso; 23rd Congress of the European Hematology Association; 2018

European Hematology Association

hypomethylating treatment by using predictive factors may maximize clinical success and minimize the exposure of inappropriatepatients to excessive toxicity.Aims: To evaluate overall survival and clinical predictive factors in an older high risk (HR) MDS and CMML cohort under HMAtreatment as well as identify patients more likely to reach response in the real world.Methods: This retrospective and multinational study was focused on older patients (>65 years old) with HR (IPSS-R>3.5 orCPSS>1). The population was selected from a Latin-American Ad-Hoc database of 340 patients who received hypomethylatingagents (HMAs) between Jan-2007 and Jan-2018. OS was evaluated as from HMA initiation, either censoring or not, other treatmentssuch as chemotherapy, other HMA or HSCT, up to time to death or last follow-up. Kaplan Meier, Log-rank test and Cox-regressionwere applied to evaluate survival. Chi2/Fisher Exact test and logistic regression were used to analyze categorical variables regardingresponse. Predictive factors included age, gender, comorbidities by Charlson Comorbidity Index (CCI), physical performance(ECOG), transfusion dependence, different cut-offs for hemoglobin level, platelet and neutrophil counts, BM and PB blasts, andkaryotypes.Results: We evaluated 138 patients (MDS 92 [67%], CMML 32 [23%], sMDS 8 [6%], and oligoblastic AML 6 [4%]) with medianfollow-up of 12.4 months and median number of HMA cycles of 7 (range 1-37). Median age was 75 (range 66-89) with a malepredominance of 57%, 34% CCI≥3, 23% ECOG ≥2 and 66% were transfusion dependent before treatment. Predictive factors ofshorter OS at treatment initiation included CCI≥3 (p=0.041), HR karyotypes (p=0.002), Hb gender-adjusted (M