A Trial of Bevacizumab in Myelodysplastic Syndromes (Int-1, Int-2 and High Risk According to International Prognostic Scoring System (IPSS)) With Excess of Marrow Blasts

Inclusion Criteria: * MDS patient with excess of marrow blasts (≥ 5%) including RAEB, RAEB-t and CMML with leucocytes \< 10 000/mm3 according to FAB classification * IPSS int-1, int-2 or high * Age \> 60 years (younger adults may be included, but only in the absence of donor for allogeneic stem cell transplantation, and if contra-indication to intensive chemotherapy) * No previous allogeneic SCT or intensive anthracycline-Ara C chemotherapy. * Adequate renal function: * Serum creatinine ≤ 1.25 x ULN or calculated creatinine clearance ≥ 50 mL/min AND * Urine dipstick for proteinuria \< 2+. Patients discovered to have ≥ 2+ proteinuria on dipstick urinalysis at baseline should undergo a 24 hour urine collection and must demonstrate ≤ 1 g of protein in 24 hours * Adequate liver function: * Total bilirubin \< 1.5 x upper limit of normal (ULN) AND Asparagine aminotransferase (AST), alanine aminotransferase (ALT) \< 2.5 x ULN in patients without liver metastases * International normalised ratio (INR) ≤1.5 and prothrombin time (PPT) ≤ 1.5 x ULN within 7 days prior to enrolment * If female, should not be pregnant or breast-feeding. Women with an intact uterus (unless amenorrhoeic for the last 24 months) must have a negative serum pregnancy test within 28 days prior to enrollment into the study. If a serum pregnancy test is not performed within 7 days prior to the first dose of bevacizumab, a confirmatory urine test (within 7 days prior to the first dose of bevacizumab) is required. * Life expectancy ≥ 6 months * Patient with health insurance * Written informed consent Exclusion Criteria: * Therapy related MDS (after chemo or radiotherapy) for a previous neoplasm or other disease including AML * A preexisting thrombocytopenia \< 20 000/mm3 * Major surgery (including open biopsy), significant traumatic injury within 28 days prior to enrolment or anticipation of the need for major surgery during study treatment * Minor surgery, including insertion of an indwelling catheter, within 24 hours prior to the first bevacizumab infusion * Prior tumor (except localized cervix carcinoma or cutaneous basal cell carcinoma) unless in remission for at least 3 years. * Uncontrolled diabetes mellitus * Current or recent (within 10 days of first dose of bevacizumab) use of aspirin (\> 325 mg/day) * Uncontrolled hypertension (blood pressures: systolic \> 150 mmHg and/or diastolic \> 100 mmHg) * Clinically significant (i.e., active) cardiovascular disease for example CVA (≤6 months before enrollment), myocardial infarction (≤ 6 months before enrollment), unstable angina, congestive heart failure NYHA Class ≥ II, serious cardiac arrhythmia requiring medication during the study and might interfere with regularity of the study treatment, or not controlled by medication * Non-healing wound, active peptic ulcer or bone fracture * History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 6 months of enrolment * Women with an intact uterus (unless amenorrhoeic for the last 24 months) not using effective, non-hormonal means of contraception (intrauterine contraceptive device, barrier method of contraception in conjunction with spermicidal jelly or surgically sterile) during the study and for a period of 6 months following the last administration of bevacizumab. Men who do not agree to use effective contraception during the study and for a period of 60 days following the last administration of bevacizumab * Investigational treatment for MDS within 6 weeks of treatment onset * Patients unable to give informed consent or to be followed up adequately * Known hypersensitivity to a product from Chinese Hamster Ovary mammalian cell or to a recombinant humanized monoclonal antibody