Chronic myelomonocytic leukemia

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4 regimens on this page
7 variants on this page


Guidelines

International expert panel

NCCN

First-line therapy

Azacitidine monotherapy

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Regimen #1, 7 days

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

Chemotherapy

28-day cycles

Regimen #2, 5-2-2

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

Chemotherapy

28-day cycle for at least 6 cycles, then continued for responders or SD until progression or intolerance.

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. 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

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Regimen #1, 7 days of azacitidine

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

Chemotherapy

28-day cycles

Regimen #2, 5-2-2 azacitidine

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

Chemotherapy

28-day cycles

References

  1. 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 #1, 7 days of azacitidine

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

Chemotherapy

28-day cycles

Regimen #2, 5-2-2 azacitidine

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

Chemotherapy

28-day cycles

References

  1. 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

Maintenance after first-line therapy

Azacitidine monotherapy

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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