| ObjectiveTo compare the clinical efficacy and safety of decitabine combined with low-dose cytarabine and decitabine in patients at high risk for myelodysplastic syndrome(MDS),and to analyze the effect of different factors on the survival of patients.MethodsThe clinical data of patients with myelodysplastic syndromes who received 4 or more courses of decitabine-based regimens and Revised International Prognostic Scoring System score >4.5 were analyzed retrospectively.And all patients were admitted in The Affiliated Hospital of Qingdao University and Qingdao Commercial Worker’s Hospital from June 2016 to January 2019.According to the different treatment regiments,they were divided into decitabine combined with low-dose cytarabine group and decitabine group.We chose SPSS 24.0 software for statistical analysis,including clinical characteristics,efficacy evaluation,survival time,adverse reactions.Results1.A total of 62 patients were included in this study,including 30 treated with decitabine combined with low-dose cytarabine and 32 treated with decitabine alone.There was no statistical difference between the two groups in the basic clinical data.2.After 4 courses of treatment,the overall response rate of decitabine combined with low-dose cytarabine group were significantly higher than that of decitabine group(90.0%(27/30)VS 62.5%(20/32),P=0.012).And the complete remission,partial remission,hematological improvement of decitabine combined with low-dose cytarabine group and decitabine group were 70.0%(21/30)VS50.0%(16/32),10.0%(3/30)VS3.1%(1/32),10.0%(3/ 30)VS9.4%(3/32)(P>0.05).3.The median progression free survival(PFS)and median overall survival(OS)of decitabine combined with low-dose cytarabine group were 21 months and 24 months;the median PFS of the decitabine group was 18 months and the median OS was 21 months(P=0.327;P=0.812).Kaplan-Meier univariate analysis showed that cytogenetic and ORR after treatment were correlated factors affecting the survival time of MDS(P=0.024;P=0.047),and the COX multivariate analysis showed there were no statistical difference in them(P>0.05).4.Cytopenia grade≥3 and infection after treatment in decitabine combined with low-dose cytarabine group was no statistical difference than that of the decitabine group,which occurred in the early stage(within the first 2 cycles)and gradually decreased later.Conclusion1.Decitabine combined with low-dose cytarabine can improve the overall response rate in patients at high risk for MDS.2.Cytogenetic and whether ORR is achieved after treatment are important factors affect the overall survival time in patients at high risk for MDS.3.Cytopenia and infection were more common occurred in early treatment of decitabine combined with low-dose cytarabine group,and the adverse reactions gradually decreased later with the course of treatment continues. |
