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Comparative analysis of remission induction therapy for high-risk MDS and AML progressed from MDS in the MDS200 study of Japan Adult Leukemia Study Group

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Abstract

A total of 120 patients with high-risk myelodysplastic syndrome (MDS) and AML progressed from MDS (MDS–AML) were registered in a randomized controlled study of the Japan Adult Leukemia Study Group (JALSG). Untreated adult patients with high-risk MDS and MDS–AML were randomly assigned to receive either idarubicin and cytosine arabinoside (IDR/Ara-C) (Group A) or low-dose cytosine arabinoside and aclarubicin (CA) (Group B). The remission rates were 64.7% for Group A (33 of 51 evaluable cases) and 43.9% for Group B (29 out of 66 evaluable cases). The 2-year overall survival rates and disease-free survival rates were 28.1 and 26.0% for Group A, and 32.1 and 24.8% for Group B, respectively. The duration of CR was 320.6 days for Group A and 378.7 days for Group B. There were 15 patients who lived longer than 1,000 days after diagnosis: 6 and 9 patients in Groups A and B, respectively. However, among patients enrolled in this trial, intensive chemotherapy did not produce better survival than low-dose chemotherapy. In conclusion, it is necessary to introduce the first line therapy excluding the chemotherapy that can prolong survival in patients with high-risk MDS and MDS–AML.

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Acknowledgments

We would like to thank the participating physicians in the Japan Adult Leukemia Study Group (JALSG) MDS200 study for their cooperation. This work was supported in part by grants-in-aid for Scientific Research from the Japanese Ministry of Education, Culture, Sport, Science, and Technology, and grants-in-aid for Cancer Research from the Japanese Ministry of Health, Labor, and Welfare.

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Authors and Affiliations

  1. Department of Hematology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Yasuyoshi Morita & Akihisa Kanamaru

  2. Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Yasushi Miyazaki & Daisuke Imanishi

  3. Department of Hematology, Saitama Medical University Hospital, Saitama, Japan

    Fumiharu Yagasaki

  4. Blood Transfusion Division, Department of Internal Medicine II, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan

    Mitsune Tanimoto

  5. Blood Immunology Laboratory, School of Health Sciences, Faculty of Medicine and University Hospital, University of the Ryukyus, Okinawa, Japan

    Kazutaka Kuriyama

  6. Department of Hematopoietic Pathobiology and Medical Oncology, Mie University Graduate School of Medicine, Tsu, Japan

    Toru Kobayashi

  7. Hyogo Prefectural Red Cross Blood Center, Hyogo, Japan

    Shion Imoto

  8. Third Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Kazunori Ohnishi

  9. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Tomoki Naoe

  10. Aichi Cancer Center, Aichi, Japan

    Ryuzo Ohno

Authors
  1. Yasuyoshi Morita
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  2. Akihisa Kanamaru
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  3. Yasushi Miyazaki
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  4. Daisuke Imanishi
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  5. Fumiharu Yagasaki
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  6. Mitsune Tanimoto
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  7. Kazutaka Kuriyama
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  8. Toru Kobayashi
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  9. Shion Imoto
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  10. Kazunori Ohnishi
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  11. Tomoki Naoe
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  12. Ryuzo Ohno
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Correspondence to Yasuyoshi Morita.

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For the Japan Adult Leukemia Study Group.

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Morita, Y., Kanamaru, A., Miyazaki, Y. et al. Comparative analysis of remission induction therapy for high-risk MDS and AML progressed from MDS in the MDS200 study of Japan Adult Leukemia Study Group. Int J Hematol 91, 97–103 (2010). https://doi.org/10.1007/s12185-009-0473-4

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  • DOI: https://doi.org/10.1007/s12185-009-0473-4

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