{
  "abstract": "Patients with high-risk myelodysplastic neoplasms or syndromes (MDS) are considered for therapy with hypomethylating agents (HMA) to help restore hematopoiesis, delay progression to acute myeloid leukemia, and improve overall survival (OS). Azacytidine (AZA) and decitabine (DEC) have commonly been used without direct clinical trial comparison between the 2 agents. Prior studies have demonstrated no difference in OS; however, these analyses are limited by the lack of patient-level and disease-risk factors that may influence efficacy and tolerability. This study retrospectively evaluated differences in clinical outcomes for patients treated with AZA or DEC, adjusting for disease-risk category and patient-specific factors, using data from the Canadian MDS registry (NCT02537990). The primary outcome for the study was OS, which was compared using the log-rank test, evaluated for the whole cohort, and then stratified by the Revised International Prognostic Scoring System (IPSS-R) disease-risk. Secondary outcomes included leukemia-free survival (LFS), change in transfusion dependence or independence status, and differences in quality-of-life (QoL) measurements. In total, 424 patients were treated with AZA (median of 10 cycles) and 85 patients were treated with DEC (median of 5 cycles). In unadjusted analysis, median OS was longer in the patients treated with DEC (37.0 vs 21.4 months; P = .001), which remained significant for patients with high-risk defined by an IPSS-R score >3.5 (34.4 vs 19.6 months; P = .01). However, in a propensity score-matched analysis, there was no difference in OS or LFS between HMA therapies. There was no significant difference in global, physical, or social QoL scores between patients treated with either HMA.",
  "abstract_shown": true,
  "affiliations": [
    "Sunnybrook Health Sciences Centre, Toronto, Canada.",
    "Princess Margaret Cancer Centre, Toronto, Canada.",
    "Tom Baker Cancer Center, Calgary, Canada.",
    "University of Alberta Hospital, Edmonton, Canada.",
    "Jewish General Hospital, Montreal, Canada.",
    "St. Paul's Hospital, Vancouver, Canada.",
    "The Ottawa Hospital, Ottawa, Canada.",
    "Juravinski Cancer Centre, Hamilton, Canada.",
    "Division of Medical Oncology and Hematology, University of Manitoba, Winnipeg, Canada.",
    "Division of Medical Oncology and Hematology, University of Florida, Gainesville, FL.",
    "Centre Hospitalier Universitaire Dr-Georges-L.-Dumont, Moncton, Canada.",
    "Vancouver General Hospital, Vancouver, Canada.",
    "Division of Hematology, Dalhousie University, Halifax, Canada.",
    "Division of Hematology, McGill University, Montreal, Canada.",
    "Saskatchewan Cancer Centre, Saskatoon, Canada.",
    "Hôpital de l'Enfant-Jésus, Laval, Canada."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 28,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "James T England"
    },
    {
      "affs": [
        0
      ],
      "name": "Liying Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Karen Yee"
    },
    {
      "affs": [
        2
      ],
      "name": "Michelle Geddes"
    },
    {
      "affs": [
        3
      ],
      "name": "Nancy Zhu"
    },
    {
      "affs": [
        4
      ],
      "name": "April Shamy"
    },
    {
      "affs": [
        5
      ],
      "name": "Heather Leitch"
    },
    {
      "affs": [
        6
      ],
      "name": "Mitchell Sabloff"
    },
    {
      "affs": [
        6
      ],
      "name": "Grace Christou"
    },
    {
      "affs": [
        7
      ],
      "name": "Brett L Houston"
    },
    {
      "affs": [
        8
      ],
      "name": "Ivan Landego"
    },
    {
      "affs": [
        7
      ],
      "name": "Brian Leber"
    },
    {
      "affs": [
        7,
        9
      ],
      "name": "Dina Khalaf"
    },
    {
      "affs": [
        7
      ],
      "name": "Alejandro Garcia-Horton"
    },
    {
      "affs": [
        10
      ],
      "name": "Eve St-Hilaire"
    },
    {
      "affs": [
        10
      ],
      "name": "Nicholas Finn"
    },
    {
      "affs": [
        11
      ],
      "name": "Thomas Nevill"
    },
    {
      "affs": [
        12
      ],
      "name": "Amy Trottier"
    },
    {
      "affs": [
        13
      ],
      "name": "John Storring"
    },
    {
      "affs": [
        14
      ],
      "name": "Mohamed Elemary"
    },
    {
      "affs": [
        15
      ],
      "name": "Robert Delage"
    },
    {
      "affs": [
        13
      ],
      "name": "Laura Habib"
    },
    {
      "affs": [
        0
      ],
      "name": "Lisa Chodirker"
    },
    {
      "affs": [
        0
      ],
      "name": "Signy Chow"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthew Cheung"
    },
    {
      "affs": [
        0
      ],
      "name": "Lee Mozessohn"
    },
    {
      "affs": [
        0
      ],
      "name": "James A Kennedy"
    },
    {
      "affs": [
        0
      ],
      "name": "Rena Buckstein"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dvbbfkcp3vkbr.bib",
  "cited_by": 0,
  "doi": "10.1016/j.bneo.2026.100293",
  "fulltext_url": "https://europepmc.org/articles/PMC13681970",
  "id": "dvbbfkcp3vkbr",
  "issns": [
    "2950-3280"
  ],
  "landing_url": "https://europepmc.org/article/MED/42903632",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Acute Myeloid Leukemia Research"
    ]
  ],
  "openalex": "W7204214328",
  "pdf_url": "https://europepmc.org/articles/PMC13681970?pdf=render",
  "pmcid": "PMC13681970",
  "pmid": "42903632",
  "published": "2026-08-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dvbbfkcp3vkbr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42903632",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42903632"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Acute Myeloid Leukemia Research",
      "subfield": "general"
    }
  ],
  "title": "A comparison of overall survival and quality of life in patients with MDS treated with azacytidine vs decitabine.",
  "title_text": "A comparison of overall survival and quality of life in patients with MDS treated with azacytidine vs decitabine.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/dvbbfkcp3vkbr",
  "venue": "Blood neoplasia",
  "versions": []
}