Azacitidine treatment for myeloid leukemia associated with Down syndrome: A nationwide retrospective study in Japan

Pediatr Blood Cancer. 2024 Oct;71(10):e31244. doi: 10.1002/pbc.31244. Epub 2024 Aug 4.

Abstract

Hypomethylating agent treatment for myeloid leukemia associated with Down syndrome (ML-DS) has been scarcely reported. Herein, we collected information on azacitidine treatment for ML-DS in Japan. Forty-eight cycles of azacitidine treatment were performed for 12 patients, including 11 relapsed or refractory (R/R) patients. In 40 cycles, azacitidine was used as monotherapy. No azacitidine-related death was observed. One cycle concurrently administered with methotrexate-based intrathecal therapy was discontinued due to toxicities. Only 4 of the 19 cycles given in non-remission achieved complete or partial remission. In conclusion, although most toxicities were acceptable, azacitidine monotherapy might be insufficient for R/R ML-DS cases.

Keywords: Azacitidine; hypomethylating agents; myeloid leukemia associated with Down syndrome; novel treatment.

MeSH terms

  • Adolescent
  • Adult
  • Antimetabolites, Antineoplastic* / adverse effects
  • Antimetabolites, Antineoplastic* / therapeutic use
  • Azacitidine* / adverse effects
  • Azacitidine* / therapeutic use
  • Child
  • Child, Preschool
  • Down Syndrome* / complications
  • Down Syndrome* / drug therapy
  • Female
  • Humans
  • Infant
  • Japan / epidemiology
  • Leukemia, Myeloid* / complications
  • Leukemia, Myeloid* / drug therapy
  • Male
  • Retrospective Studies

Substances

  • Azacitidine
  • Antimetabolites, Antineoplastic