Comparison of Decitabine Rigimen and Traditional Chemotherapy Regimen in Treatment of Patients with Intermediate or High-Risk Myelodysplastic Syndrome / 中国实验血液学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the clinical efficacy and relevant adverse reactions of homebred decitabine regimen and traditional chemotherapy regimen in treatment of patients with intermediate or high-risk myelodysplastic syndrome (MDS).</p><p><b>METHODS</b>Forty-eight patients suffered from newly diagnosed intermediate or high-risk MDS from December 2011 to December 2016 were analyzed retrospectively. Among them 29 patients were treated by traditional chemotherapy regimen, and 19 patients were treated by decitabine regimen [15 mg/(m·d), ivgtt, d1-5]. The clinical efficacy and relevant adverse reactions in two groups were compared.</p><p><b>RESULTS</b>The overall response rate (ORR) of decitabine group was 78.9% (15/19), after 2 cycles of treatment, among them 5 achieved complete remission(CR), 5 achieved partial remission(PR), and 5 achieved hematologic improvement (HI); the ORR of traditional chemotherapy group was 65.9% (16/29), including 6 CR, 5 PR, 8 HI, the ORR and remission rate (PR+CR) in decitabine treatment group were not statistically significantly different from the that in traditional chemotherapy group (x=0.458,P>0.05; x=0.499, P>0.05). After 4 cycles of treatment, the ORR in decitabine group was 84.2% (16/19), including 5 CR, 9 PR and 2 HI. The ORR in traditional chemotherapy group was 68.9% (20/29), including 6 CR, 5 PR and 9 HI. The ORR of decitabine group was not statistically significantly different from the that in traditional chemotherapy (x=0.726,P>0.05), but the remission rate was statistically significantly different(x=4.534,P<0.05). The overall survival and progression-free survival in the decitabine group were different statistically significantly different from the traditional chemotherapy (P<0.05; P<0.01). The incidences of III-IV grades adverse reactions of hemoglobin, platelet and neutrophile in the patients treated with decitabine and traditional chemotherapy group were 52.6% and 79.3% (P>0.05), 57.9% and 86.2%(P>0.05), 84.2% and 96.6%(P>0.05), respectively. The infection rates were 26.3% and 79.3%(P<0.05), respectively.</p><p><b>CONCLUSION</b>The homebred decitabine can effectively treat intermediate-or high-risk MDS, also can be well tolerated. So, it is worth to be clinically popularized.</p>