RT Journal Article
T1 Relevance of infections on the outcomes of patients with myelodysplastic syndromes, chronic myelomonocytic leukemia, and acute myeloid leukemia treated with hypomethylating agents: a cohort study from the GESMD.
A1 Vilorio-Marqués, Laura
A1 Castañón Fernández, Christelle
A1 Mora, Elvira
A1 Gutiérrez, Lorena
A1 Rey Bua, Beatriz
A1 Jiménez Lorenzo, Maria José
A1 Díaz Beya, Marina
A1 Vara Pampliega, Miriam
A1 Molero, Antonieta
A1 Sánchez-García, Joaquín
A1 Calabuig, Marisa
A1 Cedena, Maria Teresa
A1 Chen-Liang, Tzu
A1 Díaz Santa, Johana Alejandra
A1 Padilla, Irene
A1 Hernández, Francisca
A1 Díez, Rosana
A1 Asensi, Pedro
A1 Xicoy, Blanca
A1 Sanz, Guillermo
A1 Valcárcel, David
A1 Diez-Campelo, María
A1 Bernal, Teresa
K1 acute myeloid leukemia
K1 hypomethylating agent
K1 infection
K1 myelodysplastic syndrome
K1 treatment outcome
AB The consequences of infectious toxicity of hypomethylating agents (HMAs) on overall survival (OS) of patients diagnosed with high-risk myeloid neoplasms have not been thoroughly investigated. We aimed to evaluate whether infectious events (IEs) negatively influenced the results of HMA treatment in a real-world setting. Observational study. We obtained data from 412 non-selected consecutive patients from 23 Spanish hospitals who were diagnosed with high-risk myelodysplastic syndrome, chronic myelomonocytic leukemia, or acute myeloid leukemia and were treated with HMA. HMAs received after chemotherapy or stem cell transplant were excluded. All IEs were recorded. Outcomes included OS, modifications to the pre-planned treatment, incidence and characteristics of IEs, hospitalization, red blood cell transfusions, and factors associated with infection. The rate of infection was 1.2 per patient/year. Next-cycle delay (p = 0.001) and hospitalizations (p = 0.001) were significantly influenced by IEs. Transfusion requirements during each cycle were significantly higher after infection compared with cycles without infection (coefficient = 1.55 [95% confidence interval (CI) = 1.26-1.84], p 20% (HR = 1.57 [95% CI = 1.19-2.01], p 9 g/dl (HR = 0.65 [95% CI = 0.51-0.82], p  HMA infectious toxicity worsens OS, hinders the adherence to antineoplastic treatment and results in significant morbidity. Preventive strategies are fundamental in vulnerable patients.
SN 2040-6207
YR 2022
FD 2022-09-29
LK http://hdl.handle.net/10668/20232
UL http://hdl.handle.net/10668/20232
LA en
DS RISalud
RD Apr 6, 2025