{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:53:20Z","timestamp":1779360800402,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Accelerated\u2010phase (AP) or blast\u2010phase (BP) myeloproliferative neoplasms (MPNs) are associated with dismal prognosis, with non\u2010curative therapies such as hypomethylating agents (HMAs) considered in patients not eligible for intensive therapy, while some studies advocate for combination therapy with either ruxolitinib (RUXO) or venetoclax (VEN). To assess the relationship between treatment modalities and outcome, herein, we report a multicentric cohort of 149 patients (median age, 75 years) with AP\/BP MPN not eligible for intensive therapy and\/or allogeneic hematopoietic cell transplantation who received azacitidine (AZA) alone (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200960) or in combination (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200989; VEN [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200951], RUXO [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200927], or both [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20099], isocitrate dehydrogenase inhibitors [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092]) between January 2019 and October 2023. With a median follow\u2010up of 15 months, the median overall survival of the full cohort was 8.04 months, with a 3\u2010year overall survival (OS) of 13%. Among disease characteristics, OS was lower in patients with BP (6.24 vs. 18.00 months in patients with AP disease, P\u2009=\u20090.03), complex karyotype (6.00 vs. 13.08 months, P\u2009=\u20090.005), and\n                    <jats:italic>TP53<\/jats:italic>\n                    mutations (8.04 vs. 11.04 months, P\u2009=\u20090.009). OS was nonsignificantly higher in patients receiving AZA combinations (10.08 vs. 6.96 months in patients receiving AZA monotherapy, P\u2009=\u20090.12). When analyzing AZA combinations separately, patients who were treated with AZA\u2013RUXO had higher OS (18.00 vs. 9.00 vs. 10.08 months in patients receiving AZA\u2013VEN and AZA\u2013VEN\u2013RUXO, P\u2009=\u20090.015). The improved survival with AZA\u2013RUXO in the absence of complex karyotype and\/or\n                    <jats:italic>TP53<\/jats:italic>\n                    mutations warrants further prospective validation. New therapeutic options are urgently needed, especially in patients with complex karyotype and\/or\n                    <jats:italic>TP53<\/jats:italic>\n                    mutations.\n                  <\/jats:p>","DOI":"10.1002\/hem3.70202","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T15:03:33Z","timestamp":1756998213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcome of patients with accelerated and blast\u2010phase myeloproliferative neoplasms not eligible for intensive chemotherapy or allogeneic hematopoietic cell transplantation treated by azacitidine alone or in combination\u2014A FIM study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8717-0824","authenticated-orcid":false,"given":"Corentin","family":"Orvain","sequence":"first","affiliation":[{"name":"Maladies du Sang CHU Angers Angers France"},{"name":"F\u00e9d\u00e9ration Hospitalo\u2010Universitaire Grand\u2010Ouest Acute Leukemia, FHU\u2010GOAL  France"},{"name":"Universit\u00e9 d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Universit\u00e9, CRCI2NA Angers France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Tavitian","sequence":"additional","affiliation":[{"name":"H\u00e9matologie IUCT Oncopole, CHU de Toulouse Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e9mence","family":"Mediavilla","sequence":"additional","affiliation":[{"name":"H\u00e9matologie et Th\u00e9rapie Cellulaire H\u00f4pital Haut\u2010L\u00e9v\u00eaque, CHU de Bordeaux Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7oise","family":"Boyer","sequence":"additional","affiliation":[{"name":"Maladies du Sang CHU Angers Angers 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