{"id":611,"date":"2010-07-21T14:19:27","date_gmt":"2010-07-21T12:19:27","guid":{"rendered":"http:\/\/www.pjh.fr\/wordpress\/?p=611"},"modified":"2011-10-19T01:44:26","modified_gmt":"2011-10-18T23:44:26","slug":"entretien-par-vidaza-apres-induction","status":"publish","type":"post","link":"http:\/\/www.pjh.fr\/wordpress\/?p=611","title":{"rendered":"Entretien par vidaza apr\u00e8s induction"},"content":{"rendered":"<p>Une \u00e9tude prospective de phase II publi\u00e9e dans le British Journal of Haematology rapporte les r\u00e9sultats d&rsquo;un traitement d&rsquo;entretien par 5-<strong>Azacytidine <\/strong>(\u00e0 la dose de <strong>60 mg\/m2 pendant 5 jours tous les 28 jours <\/strong>par voie SC) chez des patients atteints de MDS \u00e0 haut risque, de LMMC ou de LAM secondaires \u00e0 des MDS apr\u00e8s avoir re\u00e7u un traitement d&rsquo;induction (daunorubicine + aracytine).<\/p>\n<p>On note qu&rsquo;en raison de la toxicit\u00e9 h\u00e9matologique, la dose habituelle de 75 mg\/m2 a \u00e9t\u00e9 diminu\u00e9e (ce qui n&rsquo;est pas \u00e9tonnant vu l&rsquo;exp\u00e9rience que nous avons du vidaza au quotidien).<\/p>\n<p>Il est difficile de tirer de grands enseignements de ces r\u00e9sultats faute de bras de comparaison et d&rsquo;une phase avec un bras simple surveillance ou traitement d&rsquo;entretien classique par chimioth\u00e9rapies de consolidation. C&rsquo;est faisable, 40% des patients atteignent la r\u00e9mission compl\u00e8te apr\u00e8s induction et 23 patients ont pu recevoir l&rsquo;entretien. La m\u00e9diane de survie n&rsquo;est que de 20 mois avec une dur\u00e9e de r\u00e9ponse compl\u00e8te d&rsquo;un peu plus d&rsquo;un an (13.5 mois). L&rsquo;hyperm\u00e9thylation du promoteur de CDH1 (ne me demandez pas des d\u00e9tails&#8230; mais en gros \u00e7a veut dire que le Vidaza n&rsquo;hypom\u00e9thyle pas suffisamment  \ud83d\ude06 ) \u00e9tait associ\u00e9 un faible taux de r\u00e9mission compl\u00e8te, \u00e0 une rechute pr\u00e9coce et une survie plus courte&#8230; Au niveau tol\u00e9rance, c&rsquo;est toujours un peu difficile sur le plan h\u00e9matologique avec 1\/3 de thrombop\u00e9nie et de neutrop\u00e9nie grade III-IV.<\/p>\n<p>Bref, \u00e0 voir dans une \u00e9tude de phase III.<br \/>\n<\/p>\n<div class=\"pdf24Plugin-cp\"> \t<form name=\"pdf24Form0\" method=\"post\" action=\"https:\/\/doc2pdf.pdf24.org\/wordpress.php\" target=\"pdf24PopWin\" onsubmit=\"var pdf24Win = window.open('about:blank', 'pdf24PopWin', 'resizable=yes,scrollbars=yes,width=600,height=250,left='+(screen.width\/2-300)+',top='+(screen.height\/3-125)+''); pdf24Win.focus(); if(typeof pdf24OnCreatePDF === 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jours par voie SC) chez des patients atteints de MDS \u00e0 haut risque, de LMMC ou de LAM secondaires \u00e0 des MDS [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":498,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[87],"tags":[56,43,33],"_links":{"self":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/611"}],"collection":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=611"}],"version-history":[{"count":4,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/611\/revisions"}],"predecessor-version":[{"id":804,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/611\/revisions\/804"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/media\/498"}],"wp:attachment":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=611"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=611"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=611"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}