Abstract 4285

Acute erythroleukemia (AEL) is usually characterized by cytopenias with myelodysplastic features and is frequently associated with unfavourable karyotype. AEL is associated with a poor prognosis. There is no specific therapy for AEL and results of standard induction chemotherapy have been unsatisfactory. Hypomethylating agents have been used with success in myelodysplastic syndromes (MDS) with improved overall survival (OS) of MDS patients treated with azacitidine compared to those receiving conventional care regimens in the AZA001 phase III trial. Efficacy of hypomethylating agents has also been demonstrated in small groups of AEL patients, advocating a role for these agents alone, or in combination, as first line therapy. We report 3 patients diagnosed with AEL at a single institution treated with azacitidine 500 mg/m2 every 4 weeks divided in 5 days per cycle. All cases were diagnosed according to the 2008 WHO criteria and response criteria were based on the revised recommendation of the International Working Group published in 2003.

Table 1.

Patients demographic characteristics.

PatientAgea (in years)SexCo-morbidities
1 62 M ObesityBenign prostatic hyperplasia 
2 65 M None 
3 76 M Diabetes 
PatientAgea (in years)SexCo-morbidities
1 62 M ObesityBenign prostatic hyperplasia 
2 65 M None 
3 76 M Diabetes 
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Table 2.

Patients hematological characteristics at baseline.

PatientHemoglobin(g/dL)WBC(x109/L)/ANCPlatelets (x109/L)Cytogenetic
1 8.0 1.700/0.470 60000 del(5)(q15q?(31) 
2 7.7 10.300/1.300 367000 Normal karyotype 
3 6.8 1.000/0.180 124000 45, XY, -7, del(20)(q11q13) 
PatientHemoglobin(g/dL)WBC(x109/L)/ANCPlatelets (x109/L)Cytogenetic
1 8.0 1.700/0.470 60000 del(5)(q15q?(31) 
2 7.7 10.300/1.300 367000 Normal karyotype 
3 6.8 1.000/0.180 124000 45, XY, -7, del(20)(q11q13) 
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Table 3.

Treatment characteristics and response.

PatientPrevious treatmentsTreatment durationTime to transfusion independencyBest Hematological responseTime to response
1 Conventional chemotherapy 13 cycles 4 cycles Complete remission (no cytogenetic remission) 6 cycles 
2 None 17 cycles 5 cycles Complete remission 10 cycles 
3 None 9 cycles 4 cycles Hematological improvement 4 cycles 
PatientPrevious treatmentsTreatment durationTime to transfusion independencyBest Hematological responseTime to response
1 Conventional chemotherapy 13 cycles 4 cycles Complete remission (no cytogenetic remission) 6 cycles 
2 None 17 cycles 5 cycles Complete remission 10 cycles 
3 None 9 cycles 4 cycles Hematological improvement 4 cycles 
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Therapy was well tolerated and all patients achieved transfusion independency with improvement in quality of life. At 12 months follow-up, all of them are alive, two patients are in complete sustained remission, one of whom awaits stem cell transplantation, while one patient is currently on supportive care.

These results confirm the active role of azacitidine in AEL.

Disclosures:

Almeida:Celgene: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; BMS: Speakers Bureau.

Topics:
acute erythroblastic leukemia, azacitidine, complete remission, disease remission, karyotype determination procedure, myelodysplastic syndrome, transfusion, chemotherapy regimen, chemotherapy, neoadjuvant, cytopenia

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2011 by The American Society of Hematology
2011
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