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Decitabine priming prior to low-dose chemotherapy improves patient outcomes in myelodysplastic syndromes-RAEB: a retrospective analysis vs. chemotherapy alone.
Ye, Li; Ren, Yanling; Zhou, Xinping; Mei, Chen; Ma, Liya; Ye, Xingnong; Wei, Juying; Xu, Weilai; Meng, Haitao; Qian, Wenbin; Mai, Wenyuan; Lou, Yinjun; Xu, Gaixiang; Qian, Jiejing; Lou, Yejiang; Luo, Yingwan; Xie, Lili; Lin, Peipei; Hu, Chao; Jin, Jie; Tong, Hongyan.
Afiliación
  • Ye L; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Ren Y; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
  • Zhou X; Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Mei C; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Ma L; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
  • Ye X; Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Wei J; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Xu W; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
  • Meng H; Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Qian W; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Mai W; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
  • Lou Y; Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Xu G; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Qian J; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
  • Lou Y; Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Luo Y; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Xie L; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
  • Lin P; Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Hu C; Department of Hematology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, 322000, Zhejiang, China.
  • Jin J; Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
  • Tong H; Institute of Hematology, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
J Cancer Res Clin Oncol ; 143(5): 873-882, 2017 May.
Article en En | MEDLINE | ID: mdl-28108816
ABSTRACT

PURPOSE:

The aim of this study was to examine whether decitabine priming prior to low-dose chemotherapeutic regimens could improve outcomes in patients with myelodysplastic syndromes-refractory anemia with excess of blasts (MDS-RAEB).

METHODS:

The current retrospective analysis included all MDS-RAEB patients receiving idarubicin/cytarabine (IA) or aclacinomycin/cytarabine (AA), with or without decitabine priming during a period from February 2010 to May 2015. Treatment response and toxicity were compared between patients receiving decitabine priming and those who did not. A panel of 6 MDS-related genes was examined using bone marrow specimens.

RESULTS:

A total of 81 patients were included in the

analysis:

40 received decitabine priming prior to chemotherapy (decitabine priming group). The median follow-up was 10.9 months (IQR 6.2-21.9). The rate of overall response (OR) and complete remission (CR) was significantly higher in the decitabine priming group than in the chemotherapy group (OR 75.0 vs. 51.2%, p = 0.027; CR 55.0 vs. 29.3%, p = 0.019). Overall survival (OS) did not differ significantly between the two groups (19.5 vs. 14.7 months, p = 0.082). In a subgroup analysis that included only patients at < 60 years of age, the CR rate in the decitabine priming group was significantly higher than in the chemotherapy group (65.5 vs. 31.0%, p = 0.009). Survival benefit of decitabine priming was apparent in patients at < 60 years of age (22.4 months with 95% CI of 6.7-38.1 vs. 14.7 months with 95% CI of 11.4-18.0 months in the chemotherapy group, p = 0.028), patients with intermediate and unfavorable karyotypes (22.4 months with 95% CI of 15.1-29.7 vs. 11.9 months with 95% CI of 4.0-19.8 months in the chemotherapy group, p = 0.042), and patients with mutated splicing factor genes (35.3 months with 95% CI of 21.4-49.2 vs. 17.8 months with 95% CI of 13.8-21.8 months in the chemotherapy group, p = 0.039). Grade 3-4 hematological and non-hematological toxicities were not significantly different between the two groups.

CONCLUSIONS:

Decitabine priming prior to low-dose chemotherapy could improve treatment responses in patients with MDS-RAEB.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anemia Refractaria con Exceso de Blastos / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Cancer Res Clin Oncol Año: 2017 Tipo del documento: Article País de afiliación: China
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anemia Refractaria con Exceso de Blastos / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Cancer Res Clin Oncol Año: 2017 Tipo del documento: Article País de afiliación: China