Clinical Efficacy Of Low Dose Decitabine In The Treatment Of Myelodysplastic Syndrome

Objective: To analyze the efficacy and safety of low-dose NDA methyltransferase inhibitor,decitabine,in the treatment of myelodysplastic syndromes by clinical application,and to analyze the related factors that influence the efficacy of decitabine treatment.Materials and Methods: The clinical data of 23 patients with MDS treated with low-dose decitabine in Department of Hematology of the General Hospital of Yankuang General Hospital from January 2014 to December 2016 were retrospectively analyzed,mainly through bone marrow cytology,genetics,and bone marrow biopsy.The karyotype analysis was confirmed,and according to the International Prognosis Scoring System(IPSS)score of 0.5 points,each MDS patient completed at least 1 course of decitabine demethylation treatment.All 23 patients received low-dose decitabine 15 mg/m 2 /d for 1 hour intravenous infusion for 5 days and 4 weeks for 1 course of treatment.Statistica l analysis and evaluation of the clinical treatment efficacy and incidence of adverse reactions of low-dose decitabine on MDS,analysis of related factors affecting therapeutic efficacy,and follow-up follow-up patients’ survival time.Results:(1)A total of 76 patients with MDS completed a total of 76 courses of decitabine demethylation treatment with a median of 3 courses with an average of 3.3 courses.The 18 patients showed obvious clinical curative effect and the disease was improved,the total effective rate was 78.26%,including 6 cases of CR,9 cases of m CR(7 cases of m CR with HI,2 m CR without HI),2 cases of PR,and 1 case of HI,the average of the best course of treatment was 3.25.After treatment,the median DOR was 11 months and the median PFS was 11 months.(2)Univariate analysis showed that patient age,gender,WHO classification,IPSS risk stratification,karyotype,pre-treatment platelet and hemoglobin levels,previous treatment history,platelet and red blood cell infusion dependence did not affect small doses.The efficacy of decitabine in the treatment of MDS(P > 0.05).(3)The incidence of neutropenia,thrombocytopenia,and anemia in grades III to IV was 40.79%,53.95%,and 35.52%,respectively,in 76 treatment courses;and the rate of myelosuppression was significantly higher in grades III to IV in the first 3 courses of treatment.Higher than the last 3 courses,the difference was statistically significant(P < 0.05).The infection rate was 21.05% in 76 courses,and the bleeding rate wa s 17.11%;the mortality rate was 17.39% in the bone marrow suppression period,and there was no case of discontinuation of the treatment with sititabine.(4)As of December 2016,1 patient was lost to follow-up,8 died,and 14 survived;median follow-up was 12 months,OS was 13.5 months,and median OS was 9.5 months.Conclusion: Low-dose decitabine can effectively treat MDS,especially in moderate-risk and high-risk patients;patient age,gender,WHO subtype,IPSS risk stratification,karyotype,pretreatment platelet and hemoglobin status,previous treatment history,The presence or absence of platelet and red blood cell transfusion did not affect the overall efficacy of decitabine treatment;and the incidence of serious adverse reactions of low dose decitabine in the treatment of MDS was low,mainly occurred in the first 3 courses.Therefore,the prospect of clinical application of low-dose decitabine in MDS is promising.