Effectiveness And Adverse Reactions Of CAG± Decitabine In The Treatment Of Myelodysplastic Syndromes

Objective:To compare the short-term effectiveness,adverse reactions,progression free survival(PFS)and overall survival(OS)of two different regimens(decitabine combined with CAG,CAG regimen alone)by retrospective study of patients with myelodysplastic syndromes(MDS).Methods:Retrospective analysis was performed on the patients with intermiate and high-risk myelodysplastic syndromes from March 2012 to October 2015,we chose the patients who have received 1 cycle and 2 cycle of one regimen:1.Combination of decitabine with half dose CAG(aclarubicin,Ara-c and G-CSF)chemotherapy;2.Treated with CAG chemotherapy alone(aclarubicin,Ara-c and G-CSF).We compare the complete remission(CR)rate,overall response(OR)rate and adverse effects rate of the two regimens;meanwhile,we compare the progression free survival(PFS)and overall survival(OS)of the two groups.All the data was analyzed by chi-square test,Kaplan-Meier.Results:1.In the 95 patients with newly diagnosed intermiate to high-risk MDS,we analyzed63 patients(male/famale,41/22;the ratio of gander was 1.86/1;median age was 56)who have received 2 cycles therapy.CRR in the two groups were(25%,19.4%),(37.5,32.3%)respectively,with no statistically significant differences(P>0.05).ORR in the two groups were(65.6%,38.7%),(68.75,45.2%)respectively,with statistically significant differences(P<0.05).2.Combination of decitabine with half dose CAG chemotherapy:Grade 1 or2 adverse events was oral or anal infection 9(28.1%)?6(18.75%)after 1and 2 cycle;liver and kidney functiondamage0(0%)?2(6.25%)after 1 and 2 cycle.Grade 3-4 adverse event was hematological toxicities,the average time for the lack of granulocytes was13.25±9.14 days and 12.77±8.87 days.4 patients(12.5%)and 3patients(9.38%)suffered from pulmonary infection after 1 and 2 cycle respectively.Treated with CAG chemotherapy alone :Grade 1 or2 adverse events was oral or anal infection 8(25.8%)?7(22.6%)after 1 and 2 cycle;,liver and kidney function damage 1(3.23%)?2(6.45%)after 1 and 2 cycle..Grade 3-4 adverse event was hematological toxicities,the average time for the lack of granulocytes was13.77±9.31 days and 13.31±8.16 days.6 patients(19.4%)and 3 patients(9.68%)suffered from pulmonary infection after 1 and 2 cycle respectively..There were no statistically significant differences(P>0.05)in terms of infection rates,liver and kidney function damage rates and the average time for the lack of granulocytes.3.Combination of decitabine with half dose CAG chemotherapy:The median time of disease free survival was 8 months(1-18months),the median time of overall survival was 10.25months(1-19months).Treated with CAG chemotherapy alone:The median time of disease free survival was 7months(0-16months),the median time of overall survival was 9.5 months(3-19months).There is no statistically significant between the two groups in overall survival time and in disease free survival time.Conclusion:1.Combination of decitabine with half dose CAG chemotherapy had higher CRRthan those who treated with CAG chemotherapy alone after 1 and 2 cycle therapy,but there were no statistically significant differences(P>0.05).Combination of decitabine with half dose CAG chemotherapy had higher ORR than those who treated with CAG chemotherapy alone after 1 and 2 cycle therapy,and there were statistically significant differences(P<0.05).2.There were no statistically significant differences(P>0.05)in terms of infection rates,liver and kidney function damage rates and the average time for the lack of granulocytes between the two groups.3.There is no statistically significant between the two groups in overall survival time and in disease free survival time.