Clinical Study Of Low-Dose Decitabine In The Treatment Of Myelodysplastic Syndrome And Acute Myeloid Leukemia

OBJECTIVE:To evaluate the efficacy of low-dose Decitabine on the median overall survival time and response rate of the patients with myelodysplastic syndrome or acute myeloid leukemia and to identify the survival and response associated factors.METHODS:From March2010to March2012,29consecutive patients with myelodysplastic syndrome or acute myeloid leukemia in Shandong university Qilu hospital,who received decitabine,were reviewed. Decitabine25mg/d was given intravenously over one hour for five consecutive days every four weeks. Efficacy and overall survival were analyzed by SPSS17.0software.RESULTS:As far as20patients with myelodysplastic syndrome were concerned. A median of4.5courses were delivered, The overall response rate was64%,(5complete responses,3marrow complete responses,and1hematologic improvement),? patients(50%)showed some hematologic improvement; There was no significant difference in ORR according to baseline patients’characteristics. With a median follow-up duration of5months, median overall survival was10.0months, One year survival rate was80%.9patients with acute myeloid leukemia showed no response in the end. Disease type had a significant impact on OS, Patients with MDS had significantly longer median survival time than AML, However, there was no independent prognostic factor of overall survival time of decitabine treatment by Cox proportional hazard models.Among81assessable treatment courses, there were15 fever episodes requiring intravenous antimicrobials in hospital.CONCLUSIONS:Low-dose Decitabine is effective and tolerable in the treatment for MDS. It can remarkably improve the disease control rate and disease-related symptoms, and also prolong survival in the responders. Low-dose Decitabine showed low overall response rate in the treatment for AML.