A Survival Study in Patients With High Risk Myelodysplastic Syndromes Comparing Azacitidine Versus Conventional Care

Inclusion Criteria:

Have a diagnosis of refractory anemia with excess blasts or refractory anemia with excess blasts in transformation according to the French-American-British classification system for myelodysplastic syndromes (MDS) and a relatively high risk of acute myeloid leukemia (AML) transformation, with an International Prognostic Scoring System score of INT-2 or High.
Be 18 years of age or older
Have a life expectancy of at least 3 months
Be unlikely to proceed to bone marrow or stem cell transplantation therapy following remission
Have serum bilirubin levels less than or equal to 1.5 times the upper limit of normal range for the laboratory
Have serum glutamic-oxaloacetic transaminase (aspartate aminotransferase) or serum glutamic-pyruvic transaminase (alanine aminotransferase) levels less than or equal to 2 times the upper limit of normal (unless these are considered to be related to transfusion-induced secondary hemosiderosis)
Have serum creatinine levels less than or equal to 1.5 times the upper limit of normal

Exclusion Criteria:

Secondary myelodysplastic syndromes (MDS)
Prior treatment with azacitidine;
Prior history of acute myeloid leukemia (AML);
Malignant disease diagnosed within prior 12 months;
Metastatic disease;
Hepatic tumors;
Radiation, chemotherapy, cytotoxic therapy for non-MDS conditions within prior 12 months;
Prior transplantation or cytotoxic therapy to treat MDS;
Serious medical illness likely to limit survival to 12 months or less;
Treatment with erythropoietin or myeloid growth factors during prior 21 days or androgenic hormones during prior 13 days;
Active HIV, viral hepatitis type B or C;
Treatment with investigational drugs during prior 30 days;
Within the 28-day screening period, documented red cell folate deficiency, as evidenced by red blood cell folate (not serum folate) or vitamin B12 deficiency