Meta-analysis Of The Efficacy Of Low-dose Decitabine In The Treatment Of Myelodysplastic Syndrome

Objective:The clinical efficacy of low-dose decitabine in the treatment of myelodysplastic syndrome was evaluated based on meta-analysis.Methods:Computer search Cochrane Library,PubMed,EMBase,Chinese Science Citation Database(CSCD),China Journal Full-text Database(CNKI),Chinese Science and Technology Journal Full-text Database(VIP),China Biomedical Literature Database(CBM),Wanfang Data(Wanfang Data),time As of December 2018,a randomized controlled trial(RCT)was conducted to investigate the treatment of myelodysplastic syndrome with low-dose decitabine.Two investigators independently extracted data and statistical analysis was performed on the included studies using RevMan5.3 software-Result:This study was designed to evaluate low-dose 6-15 mg/m2 decitabine with normal doses of 20-25 mg/m2 decitabine,low-dose decitabine and supportive care,and low-risk with other medications(low-risk,Efficacy and safety of intermediate-risk-1)or high-risk(medium-risk-2,high-risk)myelodysplastic syndrome.A total of 18 randomized controlled trials were included and a meta-analysis was performed on 1147 patients.The results showed that in the efficacy,whether in low-risk or high-risk patients,the total effective rate of low-dose decitabine group was higher than other drug treatments[P=0.0002,OR(95%CI)1.58,4.40]or supportive treatment[P=0.01,OR(95%CI)3.16,7.90],the difference was statistically significant(P<0.001).There was no significant difference in the efficacy of different doses of decitabine[P=0.54,OR(95%CI)0.70,1.97],In terms of the incidence of adverse reactions,the incidence of overall adverse reactions was lower in low-dose decitabine compared with the normal dose of decitabine or other drug groups[P<0.00001,OR(95%CI)0.13,0.40],the difference was statistically significant(P<0.05);there was no significant difference in the occurrence of grade III-IV myelosuppression in different doses of decitabine treatment group;the incidence of infection after low-dose decitabine treatment[P=0.68,OR(95%CI)0.60,1.54]was significantly lower than other treatments,and the difference was statistically significant(P<0.001).Conclusion:Compared with supportive and other medical treatments,decitabine is more effective in treating myelodysplastic syndromes,with a lower incidence of adverse reactions;different doses of decitabine and ?-? myelosuppression have no Significant differences,However,the incidence of infection in low-dose decitabine group is lower.This paper will provide evidence-based medical evidence for the clinical application of decitabine in the treatment of myelodysplastic syndrome.However,due to the sample size,more RCT and higher quality trials are expected to validate this study.