Myelodysplastic syndromes (MDS) are frequent diseases in elderly patients (median age: 71 years). IPSS classification defines low risk (Low and Intermediate 1), and high risk (Intermediate 2 and High) MDS. High-risk MDS (MDS-HR) have a high risk of transformation into acute leukemia with multilineage dysplasia (AML-DML). The success of Azacitidine has been mainly achieved through a rigorous empirical and clinical research, but the molecular mechanisms by which this molecule exerts its effects remain poorly characterized. The primary mode of action of Azacytidine is through DNA demethylation, and integration in to mRNA that favor traduction inhibition. The impact of this molecule on various cell death programs involved in the elimination of leukemic cells : apoptosis and autophagy is currently poorly known. The research program and clinical studies we proposed focus on two major aspects: \- Main objective: Molecular mechanism of action and resistance to Azacitidine: Role of apoptosis versus autophagy. \- Secondary Objective: Reversion of Azacytidine resistance using different drugs targeting apoptosis and/or autophagy. Our laboratory has identified new molecules to selectively induce different types of cell death (apoptosis or autophagy).
Study Type
OBSERVATIONAL
Enrollment
250
CH d'Antibes
Antibes, France
RECRUITINGCHU de Nice - Hôpital de l'Archet
Nice, France
RECRUITINGCentre Antoine Lacassagne
Nice, France
RECRUITINGCH Princesse Grace
Monaco, Monaco
RECRUITINGhematological response
Hematological response evaluated by the International Working Group (IWG) response of Cheson
Time frame: at 3 months
hematological response
Hematological response evaluated by the International Working Group (IWG) response of Cheson
Time frame: at 6 months
Overall survival
Overall survival (OS) defined as the time from start of treatment
Time frame: Day 1 of treatment
Overall survival
Overall survival (OS) defined as the time from start of treatment
Time frame: at the death
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