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Case Reports in Hematology
Volume 2012 (2012), Article ID 369086, 4 pages
http://dx.doi.org/10.1155/2012/369086
Case Report

Treatment of Chronic Myelomonocytic Leukemia with 5-Azacytidine: Case Reports

1Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky’ University, Olomouc, IP Pavlova 6, 775 20 Olomouc, Czech Republic
2First Department of Medicine, Charles University General Hospital, U nemocnice 2, 128 08 Prague, Czech Republic

Received 19 February 2012; Accepted 1 April 2012

Academic Editors: E. Bissé and K. Khair

Copyright © 2012 Peter Rohon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Epigenetic therapy with hypomethylating agent (5-azacytidine; AZA) is common in the management of specific subtypes of myelodysplastic syndrome (MDS), but there are only few studies in chronic myelomonocytic leukemia (CMML) patients. In this paper our experience with 3 CMML patients treated with AZA is described. In one patient transfusion independency was observed after 4 treatment cycles; in one case a partial response was recorded, but a progression to acute myeloid leukemia (AML) after 13 AZA cycles has appeared. In one patient, AZA in reduced dosage was administered as a bridging treatment before allogeneic stem cell transplantation (ASCT), but in the control bone marrow aspirate (before ASCT) a progression to AML was recorded. Future studies are mandatory for evaluation of new molecular and clinical features which could predict the efficiency of hypomethylating agents in CMML therapy with respect to overall survival, event-free survival, quality-adjusted life year, and pharmacoeconomy.