Study Of The Efficacy Of Decitabine And Traditional Treatment On Myelodysplastic Syndrome With Excess Blasts(MDS-RAEB)

Backgroud: Myelodysplastic syndrome(MDS)is a kind of clonal hematopoietic stem cell disease with a high degree of heterogeneity,mainly affecting the elderly.It is characterized by morbid hematopoiesis and cytopenia.MDS is divided into 5 types according to FAB classification.The refractory anemia with excess blasts(RAEB)accounts for about 23% of patients with MDS,and varies risk of progression to acute myeloid leukemia(AML).MDS is a hematological malignancy with poor prognosis,traditional treatment options combined with chemotherapy and symptomatic support.Following the application of FDA approved dicitabine(DAC)for MDS treatment,decitabine has been used for high-risk MDS as the first choice in China in recent years.The difference in the efficacy of the two programs is exploring.Objective: To compare the efficacy between decitabine and traditional treatment options.Methods:Retrospective analyzing of 84 patients with MDS-RAEB,who were newly diagnosed from January 2014 to January 2017,and 41 of them were treated with decitabine alone or combining with other chemotherapeutic agents,and 43 cases were treated with traditional treatment,then compare the clinical efficacy in both groups.Results:Responses were observed as follows :complete remission(CR)?partial remission(PR)?hematologic improvement(HI)?overall response rate(ORR)in decitabine versus traditional treatment were 8 cases(19.5%)vs 7 cases(16.3%)? 9 cases(22.0%)vs 4 cases(9.3%)?6 cases(14.6%)vs 6 cases(13.9%)?56.1% vs 39.5%,respectively?There was no statistical difference in the total response rate between the two groups.The median progression-free survival time(PFS)was 7 months(0.6-39 months)in the decitabine group and 3 months(0.3-60 months)in the traditional treatment group.There was no statistical difference in the PFS between the two groups.Conclusion:There is no significant difference between ORR and PFS in the treatment of RAEB with decitabine and conventional regimens.It is related to the small sample size and short follow-up time.Large sample clinical trials are needed to observe the long-term efficacy.