Difference between revisions of "Chronic myelomonocytic leukemia"

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|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (C)
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (C)
 
|1. [[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]]
 
|1. [[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]]
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|rowspan=2|[https://doi.org/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (C)
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (C)
 
|1. [[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]]
 
|1. [[#Azacitidine_.26_Lenalidomide|Azacitidine & Lenalidomide]]
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===References===
 
===References===
 
# Drummond MW, Pocock C, Boissinot M, Mills J, Brown J, Cauchy P, Cross NC, Hartley S, Kell J, Szubert A, Cockerill PN, Bowen DT. A multi-centre phase 2 study of azacitidine in chronic myelomonocytic leukaemia. Leukemia. 2014 Jul;28(7):1570-2. Epub 2014 Feb 26. [https://www.nature.com/leu/journal/v28/n7/full/leu201485a.html link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/24569776 PubMed]
 
# Drummond MW, Pocock C, Boissinot M, Mills J, Brown J, Cauchy P, Cross NC, Hartley S, Kell J, Szubert A, Cockerill PN, Bowen DT. A multi-centre phase 2 study of azacitidine in chronic myelomonocytic leukaemia. Leukemia. 2014 Jul;28(7):1570-2. Epub 2014 Feb 26. [https://www.nature.com/leu/journal/v28/n7/full/leu201485a.html link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/24569776 PubMed]
# '''SWOG S1117:''' Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. [https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/28486043 PubMed]
+
# '''SWOG S1117:''' Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. [https://doi.org/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/28486043 PubMed]
  
 
==Azacitidine & Lenalidomide {{#subobject:92571f|Regimen=1}}==
 
==Azacitidine & Lenalidomide {{#subobject:92571f|Regimen=1}}==
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!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
|rowspan=2|[https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
+
|rowspan=2|[https://doi.org/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
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!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
|rowspan=2|[https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
+
|rowspan=2|[https://doi.org/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
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===References===
 
===References===
# '''SWOG S1117:''' Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. [https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/28486043 PubMed]
+
# '''SWOG S1117:''' Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. [https://doi.org/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/28486043 PubMed]
  
 
==Azacitidine & Vorinostat {{#subobject:a816bd|Regimen=1}}==
 
==Azacitidine & Vorinostat {{#subobject:a816bd|Regimen=1}}==
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!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
|rowspan=2|[https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
+
|rowspan=2|[https://doi.org/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
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!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
|rowspan=2|[https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
+
|rowspan=2|[https://doi.org/10.1200/JCO.2015.66.2510 Sekeres et al. 2017 (SWOG S1117)]
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|rowspan=2 style="background-color:#91cf61"|Randomized Phase II, <20 pts in subgroup (E-esc)
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
 
|1. [[#Azacitidine_monotherapy|Azacitidine]]
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===References===
 
===References===
# '''SWOG S1117:''' Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. [https://ascopubs.org/doi/full/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/28486043 PubMed]
+
# '''SWOG S1117:''' Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. [https://doi.org/10.1200/JCO.2015.66.2510 link to original article] '''contains verified protocol''' [https://pubmed.ncbi.nlm.nih.gov/28486043 PubMed]
  
 
==Decitabine monotherapy {{#subobject:c9cd47|Regimen=1}}==
 
==Decitabine monotherapy {{#subobject:c9cd47|Regimen=1}}==

Revision as of 17:57, 7 March 2020

Section editor
Sanjay mohan.png
Sanjay R. Mohan, MD, MSCI
Vanderbilt University
Nashville, TN
7 regimens on this page
10 variants on this page


Guidelines

International expert panel

NCCN

First-line therapy

Azacitidine monotherapy

back to top

Regimen variant #1, 7 days

Study Evidence Comparator Comparative Efficacy
Sekeres et al. 2017 (SWOG S1117) Randomized Phase II, <20 pts in subgroup (C) 1. Azacitidine & Lenalidomide Seems not superior
2. Azacitidine & Vorinostat Seems not superior

Chemotherapy

28-day cycles

Regimen variant #2, 5-2-2

Study Evidence Comparator Comparative Efficacy
Drummond et al. 2014 Phase II
Sekeres et al. 2017 (SWOG S1117) Randomized Phase II, <20 pts in subgroup (C) 1. Azacitidine & Lenalidomide Seems not superior
2. Azacitidine & Vorinostat Seems not superior

Chemotherapy

28-day cycle for at least 6 cycles

References

  1. Drummond MW, Pocock C, Boissinot M, Mills J, Brown J, Cauchy P, Cross NC, Hartley S, Kell J, Szubert A, Cockerill PN, Bowen DT. A multi-centre phase 2 study of azacitidine in chronic myelomonocytic leukaemia. Leukemia. 2014 Jul;28(7):1570-2. Epub 2014 Feb 26. link to original article contains verified protocol PubMed
  2. SWOG S1117: Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. link to original article contains verified protocol PubMed

Azacitidine & Lenalidomide

back to top

Regimen variant #1, 7 days of azacitidine

Study Evidence Comparator Comparative Efficacy
Sekeres et al. 2017 (SWOG S1117) Randomized Phase II, <20 pts in subgroup (E-esc) 1. Azacitidine Seems not superior
2. Azacitidine & Vorinostat Not reported

Chemotherapy

28-day cycles

Regimen variant #2, 5-2-2 azacitidine

Study Evidence Comparator Comparative Efficacy
Sekeres et al. 2017 (SWOG S1117) Randomized Phase II, <20 pts in subgroup (E-esc) 1. Azacitidine Seems not superior
2. Azacitidine & Vorinostat Not reported

Chemotherapy

28-day cycles

References

  1. SWOG S1117: Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. link to original article contains verified protocol PubMed

Azacitidine & Vorinostat

back to top

Regimen variant #1, 7 days of azacitidine

Study Evidence Comparator Comparative Efficacy
Sekeres et al. 2017 (SWOG S1117) Randomized Phase II, <20 pts in subgroup (E-esc) 1. Azacitidine Seems not superior
2. Azacitidine & Lenalidomide Not reported

Chemotherapy

28-day cycles

Regimen variant #2, 5-2-2 azacitidine

Study Evidence Comparator Comparative Efficacy
Sekeres et al. 2017 (SWOG S1117) Randomized Phase II, <20 pts in subgroup (E-esc) 1. Azacitidine Seems not superior
2. Azacitidine & Lenalidomide Not reported

Chemotherapy

28-day cycles

References

  1. SWOG S1117: Sekeres MA, Othus M, List AF, Odenike O, Stone RM, Gore SD, Litzow MR, Buckstein R, Fang M, Roulston D, Bloomfield CD, Moseley A, Nazha A, Zhang Y, Velasco MR, Gaur R, Atallah E, Attar EC, Cook EK, Cull AH, Rauh MJ, Appelbaum FR, Erba HP. Randomized phase II study of azacitidine alone or in combination with lenalidomide or with vorinostat in higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia: North American Intergroup Study SWOG S1117. J Clin Oncol. 2017 Aug 20;35(24):2745-2753. Epub 2017 May 9. link to original article contains verified protocol PubMed

Decitabine monotherapy

back to top

Regimen

Study Evidence Efficacy
Santini et al. 2017 Phase II ORR: 48%

Chemotherapy

28-day cycles

References

  1. Santini V, Allione B, Zini G, Gioia D, Lunghi M, Poloni A, Cilloni D, Sanna A, Masiera E, Ceccarelli M, Abdel-Wahab O, Terenzi A, Angelucci E, Finelli C, Onida F, Pelizzari A, Ferrero D, Saglio G, Figueroa M, Levis A. A phase II, multicentre trial of decitabine in higher-risk chronic myelomonocytic leukemia. Leukemia. 2018 Feb;32(2):413-418. Epub 2017 Jun 13. link to original article link to PMC article contains verified protocol PubMed

Maintenance after first-line therapy

Azacitidine monotherapy

back to top

Regimen

Study Evidence
Grövdal et al. 2010 Phase II

Chemotherapy

28-day cycles

References

  1. Grövdal M, Karimi M, Khan R, Aggerholm A, Antunovic P, Astermark J, Bernell P, Engström LM, Kjeldsen L, Linder O, Nilsson L, Olsson A, Holm MS, Tangen JM, Wallvik J, Oberg G, Hokland P, Jacobsen SE, Porwit A, Hellström-Lindberg E. Maintenance treatment with azacytidine for patients with high-risk myelodysplastic syndromes (MDS) or acute myeloid leukaemia following MDS in complete remission after induction chemotherapy. Br J Haematol. 2010 Aug;150(3):293-302. Epub 2010 May 20. link to original article contains verified protocol PubMed content property of HemOnc.org