CR with Partial Hematologic Recovery Leads to Similar Outcomes in MDS Compared with CR

Patients with myelodysplastic syndromes (MDS) who have a complete response (CR) with partial hematologic recovery have “similar survival and duration on therapy” as patients who achieve a CR, according to a recent study.

Andrew M. Brunner, MD, of Massachusetts General Hospital and Harvard Medical School, and colleagues conducted the study because CR with partial hematologic recovery has been evaluated in acute myeloid leukemia, but “its relevance is unknown in MDS.”

Dr. Brunner and colleagues identified 311 patients with MDS who received DNA methyltransferase inhibitors between 2007 and 2018 and evaluated their best overall response according to the International Working Group (IWG) 2006 criteria. The median patient age at the time of therapy was 69 years, with a median follow-up of 60 months.

Per the IWG 2006 criteria, 14% of patients had a CR, 1% had a partial response, 18% had marrow CR, 48% had stable disease, 19% had progressive disease, and 25 achieved hematologic improvement.

Of those patients, 20% had CR with partial hematologic recovery, with 8% of those patients having marrow CR and 38% having stable disease. Patients who achieved a CR and those who achieved a CR with partial hematologic recovery had similar times on therapy, with a median of 8.1 months in patients achieving a CR and a median of six months in those achieving a CR with partial hematologic recovery. Overall survival (OS) “varied according to response,” with a median OS of 23.3 months in patients with a CR, an OS of 25 months in patients with a CR and partial hematologic recovery, a median OS of 17.2 months in those with a marrow CR, a median OS of 16.3 months in those with stable disease, and a median OS of 8.7 months in those with progressive disease.

“MDS patients who achieve a CR [with partial hematologic recovery] had similar survival and duration on therapy as patients who achieve CR response and superior to other IWG responses,” Dr. Brunner and colleagues concluded. “These data support further evaluation of CR [with partial hematologic recovery] into future response criteria and clinical trials.”

Reference

Brunner AM, Gavralidis A, Ali NA, et al. Evaluating complete remission with partial hematologic recovery (CRh) as a response criterion in myelodysplastic syndromes (MDS). Blood Cancer J. 2022;12(11):153. doi:10.1038/s41408-022-00748-9