@article{3078097,
    title = "Chronic myelomonocytic leukemia treated with 5-azacytidine–results from the Hellenic 5-Azacytidine Registry: proposal of a new risk stratification system",
    author = "Diamantopoulos, P.T. and Kotsianidis, I. and Symeonidis, A. and Pappa, V. and Galanopoulos, A. and Gogos, D. and Karakatsanis, S. and Papadaki, H. and Palla, A. and Hatzimichael, E. and Dimou, M. and Papageorgiou, S. and Delimpasis, S. and Papaioannou, M. and Papoutselis, M. and Kourakli, A. and Tsokanas, D. and Anagnostopoulos, A. and Kontos, C.K. and Panayiotidis, P. and Viniou, N.-A. and On behalf of the Hellenic MDS study group",
    journal = "Clinical Lymphoma Myeloma and Leukemia",
    year = "2019",
    volume = "60",
    number = "7",
    pages = "1721-1730",
    publisher = "Taylor and Francis Ltd.",
    doi = "10.1080/10428194.2018.1540783",
    keywords = "azacitidine;  ferritin;  hemoglobin;  antineoplastic antimetabolite;  azacitidine, adult;  aged;  Article;  blast cell;  blood toxicity;  cancer free survival;  cancer prognosis;  cancer survival;  chronic myelomonocytic leukemia;  drug dose reduction;  drug withdrawal;  Dusseldorf score;  female;  ferritin blood level;  hemoglobin blood level;  high risk population;  human;  infection;  major clinical study;  male;  median survival time;  monotherapy;  multiple cycle treatment;  overall survival;  platelet count;  priority journal;  risk assessment;  scoring system;  stratification;  survival rate;  treatment response;  acute myeloid leukemia;  chronic myelomonocytic leukemia;  follow up;  middle aged;  mortality;  pathology;  procedures;  prognosis;  register;  retrospective study;  risk factor;  very elderly, Adult;  Aged;  Aged, 80 and over;  Antimetabolites, Antineoplastic;  Azacitidine;  Female;  Follow-Up Studies;  Humans;  Leukemia, Myeloid, Acute;  Leukemia, Myelomonocytic, Chronic;  Male;  Middle Aged;  Prognosis;  Registries;  Retrospective Studies;  Risk Assessment;  Risk Factors;  Survival Rate",
    abstract = "Hypomethylating agents are widely used in chronic myelomonocytic leukemia (CMML). We analyzed the characteristics of 88 patients with CMML homogeneously treated with 5-azacytidine (Hellenic 5-Azacytidine Registry). The overall response rate was 48.9% and the median overall survival (OS) 29.7 months. Out of the seven most widely used prognostic scoring systems for CMML, the Dusseldorf score (DUSS) showed the best prognostic capability (HR, 2.27; p <.001). Forty-one (48.8%) patients progressed to acute myeloid leukemia (AML) after a median time of 15.2 months following treatment initiation. High serum ferritin levels at diagnosis were independently correlated with low OS (HR, 2.84; p =.022), as were circulating blasts (HR, 3.47; p =.014), while a platelet count <100 × 109/L was marginally predictive of lower OS (HR, 1.45; p =.06). We selected these three factors to create a new risk stratification system for CMML with three risk groups. Finally, we highlighted for the first time the prognostic significance of serum ferritin levels in CMML. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group."
}