Antineoplastics
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Reactions 1391 - 3 Mar 2012 S Antineoplastics Myelodysplastic syndromes, treated with azacitidine: 4 case reports Four men with non-Hodgkin’s lymphoma (NHL) developed myelodysplastic syndromes after receiving antineoplastics [dosages and routes not stated]; three of them responded to treatment with azacitidine. A 54-year-old man received fludarabine, cyclophosphamide and rituximab (FCR regimen) from June to November 2008 (6 cycles). He achieved complete remission in January 2009 and remained off therapy for 13 months, when cytopenia was noted. In February 2010, bone marrow analysis revealed severe trilineage dysplasia with 10% blast cells and cytogenetic aberrations. He received azacitidine 75 mg/m 2 according to a 5+2+2 schedule (5 days on, 2 days off, 2 days on). After the fourth cycle, his blood counts showed normal values, and bone marrow examination revealed absence of blast cells and a complete cytogenetic response. He continued azacitidine treatment while waiting for a bone marrow transplant. A 62-year-old man started chemotherapy with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone (R-CHOP; 6 cycles) from September 2005 to January 2006. He then received ifosfamide, epirubicin and etoposide (IEV; 3 cycles) from February to May 2007, followed by rituximab, dexamethasone, cytarabine and cisplatin (R-DHAP) from March to July 2008. After a relapse in November 2008, he received ibritumomab tiuxetan [duration of treatment not stated]. In November 2009, 4 months after completing chemotherapy with vincristine, doxorubicin, etoposide, cyclophosphamide, bleomycin and prednisolone (P-VABEC; 8 cycles), he developed refractory cytopenia with multilineage dysplasia. Tests showed 4% bone marrow blast cells and cytogenetic aberrations. He received erythropoietin and transfusions and started receiving azacitidine 75 mg/m 2 in March 2010 according to a 5+2+2 schedule. His blood counts had improved after 5 cycles, but he died in August 2010 from cardiac failure. A man was diagnosed with large B-cell NHL in May 1997 at 42 years of age and received 6 cycles of methotrexate, folinic acid [leucovorin], doxorubicin, cyclophosphamide, vincristine, bleomycin and prednisone (MACOP-B), followed by a stem cell transplant. In June 2009, he presented with severe anaemia, thrombocytopenia and leucopenia. Bone marrow analysis showed severe trilineage dysplasia with 5% blast cells. He started receiving azacitidine in October 2010, and after 5 cycles, bone marrow analysis showed absence of blast cells and moderate dysplasia. He continued azacitidine treatment while waiting for a bone marrow transplant. A 66-year-old man received cyclophosphamide, vincristine, doxorubicin and prednisone (CHOP) from September 2000 to August 2001. After a relapse in June 2006, he received 6 cycles of FCR until December 2006, followed by 3 cycles of rituximab alone until April 2008. In January 2010, he developed anaemia, leucopenia and thrombocytopenia. He was diagnosed with refractory cytopenia, with multilineage dysplasia and cytogenetic aberrations. From July 2010, he received 6 cycles of azacitidine but did not respond. Bone marrow analysis, performed after the fifth cycle, revealed persistent trilineage dysplasia. Breccia M, et al. 5’-Azacitidine for therapy-related myelodysplastic syndromes after non-Hodgkin lymphoma treatment. Leukemia Research 35: 1409-11, No. 10, Oct 2011 - Italy 803067617 1 Reactions 3 Mar 2012 No. 1391 0114-9954/10/1391-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1391 - 3 Mar 2012
SAntineoplastics
Myelodysplastic syndromes, treated withazacitidine: 4 case reports
Four men with non-Hodgkin’s lymphoma (NHL)developed myelodysplastic syndromes after receivingantineoplastics [dosages and routes not stated]; three ofthem responded to treatment with azacitidine.
A 54-year-old man received fludarabine,cyclophosphamide and rituximab (FCR regimen) from Juneto November 2008 (6 cycles). He achieved completeremission in January 2009 and remained off therapy for13 months, when cytopenia was noted. In February 2010,bone marrow analysis revealed severe trilineage dysplasiawith 10% blast cells and cytogenetic aberrations. Hereceived azacitidine 75 mg/m2 according to a 5+2+2schedule (5 days on, 2 days off, 2 days on). After the fourthcycle, his blood counts showed normal values, and bonemarrow examination revealed absence of blast cells and acomplete cytogenetic response. He continued azacitidinetreatment while waiting for a bone marrow transplant.
A 62-year-old man started chemotherapy with rituximab,cyclophosphamide, vincristine, doxorubicin andprednisone (R-CHOP; 6 cycles) from September 2005 toJanuary 2006. He then received ifosfamide, epirubicin andetoposide (IEV; 3 cycles) from February to May 2007,followed by rituximab, dexamethasone, cytarabine andcisplatin (R-DHAP) from March to July 2008. After a relapsein November 2008, he received ibritumomab tiuxetan[duration of treatment not stated]. In November 2009,4 months after completing chemotherapy with vincristine,doxorubicin, etoposide, cyclophosphamide, bleomycinand prednisolone (P-VABEC; 8 cycles), he developedrefractory cytopenia with multilineage dysplasia. Testsshowed 4% bone marrow blast cells and cytogeneticaberrations. He received erythropoietin and transfusionsand started receiving azacitidine 75 mg/m2 in March 2010according to a 5+2+2 schedule. His blood counts hadimproved after 5 cycles, but he died in August 2010 fromcardiac failure.
A man was diagnosed with large B-cell NHL in May 1997at 42 years of age and received 6 cycles of methotrexate,folinic acid [leucovorin], doxorubicin, cyclophosphamide,vincristine, bleomycin and prednisone (MACOP-B),followed by a stem cell transplant. In June 2009, hepresented with severe anaemia, thrombocytopenia andleucopenia. Bone marrow analysis showed severetrilineage dysplasia with 5% blast cells. He started receivingazacitidine in October 2010, and after 5 cycles, bonemarrow analysis showed absence of blast cells andmoderate dysplasia. He continued azacitidine treatmentwhile waiting for a bone marrow transplant.
A 66-year-old man received cyclophosphamide,vincristine, doxorubicin and prednisone (CHOP) fromSeptember 2000 to August 2001. After a relapse in June2006, he received 6 cycles of FCR until December 2006,followed by 3 cycles of rituximab alone until April 2008. InJanuary 2010, he developed anaemia, leucopenia andthrombocytopenia. He was diagnosed with refractorycytopenia, with multilineage dysplasia and cytogeneticaberrations. From July 2010, he received 6 cycles ofazacitidine but did not respond. Bone marrow analysis,performed after the fifth cycle, revealed persistenttrilineage dysplasia.Breccia M, et al. 5’-Azacitidine for therapy-related myelodysplastic syndromesafter non-Hodgkin lymphoma treatment. Leukemia Research 35: 1409-11, No. 10,Oct 2011 - Italy 803067617
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Reactions 3 Mar 2012 No. 13910114-9954/10/1391-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
