Analysis Of Clinical Efficacy And Influencing Factors Of Demethylated Drug Treatment On MDS

Purpose:The clinical effects and influencing factors of the demethylated drugs decitabine and azacitidine in the treatment of myelodysplastic syndromes(MDS)were summarized and analyzed.Methods:1.Retrospective analysis of pre-treatment case data of 39 patients with myelodysplastic syndrome(MDS)treated with demethylation drugs from January 1,2015,to March 1,2020,Department of Hematology,Hunan Provincial People’s Hospital,Includes: gender,age,physical fitness score(ECOG),MDS typing,bone marrow blast cell ratio,bone marrow karyotype,revised International Prognostic Score System(IPSS-R)and IPSS-R risk classification,peripheral blood neutrality Granulocyte count,hemoglobin,platelet count and other data.Comparison of different indicators of decitabine and azacitidine before and after treatment.2.Comparing the clinical efficacy indexes of decitabine and azacitidine,the observation indexes include: hematology improvement(neutrophil response 、hemoglobin response、platelet response),bone marrow response(partial bone marrow response,complete bone marrow response),total response(hematological response and bone marrowresponse),event-free survival(EFS),total survival(OS).22 cases of decitabine and 17 cases of azacitidine were divided into decitabine response group and decitabine non-response group,azacitidine response group and azacitidine.To understand whether there was any difference in response rate and prognostic survival time in MDS between decitabine and azacitidine treatment.3.Analysis of prognostic factors between the reaction group and non-response group of decitabine and azacitidine showed that: Compare the differences in event-free survival and overall survival between decitabine,azacitidine-responsive and non-response groups,and analyze their influencing factors,that is,physiological indicators: age,gender;clinical indicators: newly treated hemogram(including middle Neutrophil count,hemoglobin,platelet count),the proportion of bone marrow blasts,karyotype,adverse reactions during treatment.Understand the effect of different factors on the response of decitabine and azacitidine to patients with MDS.4.Comparative analysis of the effect of TP53 gene mutation on the clinical efficacy of demethylated drugs(decitabine or azacitidine)in patients with MDS.Results:1.Of the 39 demethylated patients,22 were decitabine and 17 were azacitidine.Sex,age,MDS classification,IPSS-R risk classification,ECOG score,neutrophil count before treatment,Hemoglobin,platelet count,and bone marrow blast count were analyzed.Except for age,there was no statistical difference in other indicators.2.In decitabine and azacitidine,the clinical efficacy analysis results showed no significant difference in hematological response,complete remission of bone marrow,and no significant difference between the two groups(p> 0.05).At the same time,there was no statistical difference in event-free survival time(EFS)and overall survival time(OS)between the two groups(p> 0.05).3.Analysis of the prognostic factors between the response and non-response groups of decitabine and azacitidine showed that: There was a statistically significant difference in EFS and OS between the decitabine response group and the non-response group,Bone marrow blasts(%)have an effect on prognostic survival(p <0.05);there was a statistical difference between EFS in the azacitidine response group and the non-response group.4.Demethylation drug treatment of MDS,whether the patient is associated with TP53 gene mutation,has no statistically significant effect on clinical response rate(p>0.05).In conclusion:1.Patients with the myelodysplastic syndrome were treated with demeth ylation,and there was no statistical difference in clinical efficacybetween decitabine group and azacitidine group.2.Patients with the myelodysplastic syndrome had significant diff-erences in EFS and OS between decitabine and non-response groups,Bone marrow blasts(%)have an effect on prognostic survival(p <0.05).There was only a statistically significant difference in EFS between the response and non-response groups in the azacitidine treatment group.3.TP53 gene mutation has no effect on the efficacy of demethylation therapy for myelodysplastic syndrome.