CC‐486 (oral azacitidine) is an epigenetic modifier in clinical development for treatment of hematological cancers. This study of extended CC‐486 dosing included patients with myelodysplastic syndromes (MDSs), chronic myelomonocytic leukemia (CMML), or acute myeloid leukemia (AML). After a pharmacokinetic assessment period, 31 patients (MDS n = 18, CMML n = 4, and AML n = 9) entered a clinical phase in which they received CC‐486 300 mg once‐daily for 21 days of repeated 28‐day cycles. Median age was 71 years (range: 53‐93); 42% of patients were aged ≥75 years. A total of 5 patients with AML (63%) had prior MDS. Median number of CC‐486 treatment cycles was 4 (range: 1‐32). The most common treatment‐emergent adverse events (TEAEs) were gastrointestinal (84% of patients) and hematologic (81%). Most common grade 3‐4 TEAEs were neutropenia (n = 13, 42%) and anemia (n = 9, 29%). Ten patients experienced grade 4 neutropenia. Infrequently, CC‐486 dose was interrupted or reduced due to gastrointestinal (n = 5, 16%) or hematologic (n = 6, 19%) TEAEs. Overall response rate (complete remission [CR], CR with incomplete hematological recovery [CRi], partial remission [PR], marrow CR) in the MDS/CMML subgroups was 32% and in the AML subgroup (CR/CRi/PR) was 22%. Red blood cell transfusion independence rates in the MDS/CMML and AML subgroups were 33% and 25%, respectively, and 2 MDS/CMML patients attained hematologic improvement as a best response on‐study. No baseline gene mutation was predictive of response/nonresponse. CC‐486 allows flexible dosing and schedules to improve tolerability or response. Neutropenia in early treatment cycles deserves scrutiny and may warrant initiation of prophylactic antibiotics.KEY POINTSThe safety profile of oral CC‐486 was comparable to that of injectable azacitidine; most adverse events were hematological and gastrointestinal.Extended (21‐day/cycle) CC‐486 dosing induced responses in patients with hematological malignancies, many of whom had prior DNMTi failure.

Fourteen cases of thoracic intervertebral disc prolapse are reported and analysed. Eleven were women, 3 men, and the peak incidence was in the 5th decade. No trauma was reported in our cases. The T8/9 interspace was the most frequently involved. A sensory level was noticed in 6 cases and in four a clear cut sensory level at T10 was observed. Results of surgical treatment show that using microsurgical techniques costotransversectomy and its modifications are equally effective; laminectomy is contraindicated.

A case report of an adult patient with an osteoid osteoma of the body of the 3rd cervical vertebra is presented. The long history of progressively worsening nocturnal cervical pain which was relieved by non-steroidal anti-inflammatory drugs, and an essentially normal clinical examination, are typical of this condition; in which CT is the investigation of choice. Complete relief was obtained following excision of the lesion. The literature is reviewed.

In the small and diverse group of atypical, non-neoplastic intramedullary spinal cord lesions, parasitic infections are rarely considered, especially in Caucasian patients without systemic complaints or eosinophilia. A case of atypical myelopathy caused by Schistosoma haematobium is presented. The clinical, laboratory and imaging features in the MRI era both before and after treatment are discussed.

A case of regression of a probable cerebral metastasis of a hypernephroma after nephrectomy and hormone therapy is presented. The patient subsequently developed a meningioma after therapy with medroxyprogesterone acetate. A relationship between meningioma growth and sex hormones has been documented, but little is known about the effect of hormone therapies on tumour growth.