[Clinical Efficacy and Prognostic Factors of Decitabine for Treatment of Myelodysplastic Syndrome].

OBJECTIVE: To explore the clinical efficacy of decitabine for treatment of patients with myelodysplastic syndrome (MDS) and factors predicting the prognosis. METHODS: The clinical data of 87 patients with MDS treated with decitabine were analyzed retrospectively. The hENT1 mRNA expression and TP53 gene mutation were detected by Q-PCR and gene target sequencing, respectively. The relationship of clinical characteristics and molecular indicators with the clinical response to decitabine was analyzed. RESULTS: In treatment for median 4 (2-17) courses, a total 51 patients (58.6%) showed therapeutic responses, including CR in 17 cases, PR in 12 cases, mCR in 9 cases, HI in 13 cases; 36 (41.4%) patients showed non-response. Univariate analysis showed that the patients with the complex karyotype, monosomal karyotype, chomosome 7 abnormality and Plt count doubling after 1 course treatment had a high CR rate, while the patients with relative high risk by IPSS (intermediate risk 2+ high risk), complex karyotype and Plt count doubling after 1 course had much more high overall remission rate (ORR). The expression level of hENT1 mRNA in MDS patients with response was significantly higher than that in patients without response ï¼»(1.78±1.45 (2-△△Ct) vs 0.96±0.97 (2-△△Ct)(P= 0.002)ï¼½. Among 51 patients with therapeutic response, the expression level of hENT1 mRNA in CR group was higher than that in non-CR group ï¼»(2.58±1.44 (2-△△Ct) vs 1.39 ±1.3 (2-△△Ct), P= 0.005)ï¼½. Among 52 patients in relative high risk (intermediate risk 2 +high risk), the median OS time of patients with high hENT1 mRNA expression was significantly longer than that of patients with low hENT1 mRNA expression (31 vs 12 months)(P<0.001). Among 87 patients received decitabine treatment, the TP53 gene mutation occured in 11 (12.6%) patients. The ORR in patients with TP53 mutation was high (P=0.04), moreover the patients with TP53 mutation more easily gained CR (P<0.001). Multivariate logistic regression model showed that the complex karyotype, Plt count doubling after 1 course treatment, TP53 mulation and high expression of hENT1 mRNA were the independent prognostic factors for predicting the CR after decitabine treatment. CONCLUSION: IPSS staging, complex karyotype, Plt count doubling after 1 course treatment and hENT1 mRNA expression, TP53 gene mutation can be used to predict the tharapeutic efficacy of dectitabine for treatment of MDS.

[Expression of cyclooxygenase-2 in bone marrow cells of chronic leukemia and its significance].

The study was aimed to investigate the expression of COX-2 in bone marrow cells of chronic leukemia patients and its potential pathogenetic implications. Western blot was applied for detecting COX-2 expression levels in bone marrow cells of 67 chronic leukemia patients and beta-actin expression levels. Bone marrow aspirations from 14 healthy donors were used as negative controls. The results showed that the positive rates of COX-2 in chronic-phase group of chronic myeloid leukemia (CML-CP) and in group of chronic lymphocytic leukemia (CLL) were 76.32% (29/38) and 75.86% (22/29) respectively. Both CML-CP and CLL group showed a higher expression than control group (p = 0.0000, p = 0.0000 respectively). The expression of LDH in Cox-2 positive group was higher than that in Cox-2 negative group, and the difference between the two groups was statistically significant (p < 0.001). It is concluded that the expression of COX-2 protein can be detected in bone marrow cells of CML-CP and CLL and the expression level of LDH were higher in cells of CML-CP and CLL. The expression of COX-2 may be correlated with prognosis of CML-CP and CLL.