The Comparative Analysis Of Patients Of Myelodysplastic Syndromes With Karyotype And Two Regimens Of Treatments

Objective Myelodysplastic syndromes(MDS) are a group of clonal hematologic malignancies having heterogeneity. It originated from dysplastic hematopoietic stem cells and dysplastic progenitor cells, which lead to ineffective hematopoiesis and the high conversion rate to acute myeloid leukemia. Clinically, the ineffective hematopoiesis and the decreasing of three-line in peripheral blood are the main feature of it. The chromosome abnormalities play an important role in the course of the development of MDS, and in the time of initial diagnosis the detection rate of abnormal karyotype are up to 40%-70%, with the progression of the disease the rate will be up to 80%. Currently, it is accepted that the treatment drug of myelodysplastic syndrome is decitabine, which is considered to be the most effective DNA methyltransferase inhibitor and can lead to the activeation of tumor suppressor genes and induce cell differentiation. In this study, our goals are to investigate the relationship between cytogenetic markers and prognosis in cases with primary myelodysplastic syndromes(MDS) and to observe the clinical safety and efficacy of DNA methyltransferase inhibitor of decitabine involving 3-day regimen and 5-day regimen in patients of myelodysplastic syndromes(MDS).Methods The clinical data of 48 patients(3-day 20,5-day 28) for MDS were retrospectively analyzed. The relationship between karyotype and prognosis was analyzed. The adverse effect and efficacy of the two regimens by two courses of the decitabine were observed and compared.Results Twenty out of 48 patients(41.67%) showed karyotypic abnormalities.The rate of abnormal karyotype in RAEB-1、RAEB-2 were much higher than others MDS. An analysis based on IPSS-R Scoring System showed that advanced risk stratification gradually enhanced the incidence of karyotypic abnormalities(P<0.05).In addition,the probability of evolution to leukemia increased with the higher IPSS-R score(P<0.05).There was no significant difference between the two regimens in the overall response rate(3-day 30% vs 5-day 46.43% P>0.05).Adverse events involving myelosuppression,infection and bleeding,were mainly caused by decitabine,and the incidences of adverse effect in 5-day regimen were significantly lower than 3-day regimen(P<0.05).Conclusions Karyotype analysis has a great value for the diagnosis and prognosis of MDS.The efficacy of 3-day regimen and 5-day regimen was similar,and the incidences of adverse effect in 3-day regimen were significantly higher than 5-day regimen,which is valuable for popularization.