Very-low-dose decitabine treatment for patients with intermediate- or high-risk myelodysplastic syndrome: a retrospectiv
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ORIGINAL ARTICLE
Very-low-dose decitabine treatment for patients with intermediateor high-risk myelodysplastic syndrome: a retrospective analysis of thirteen cases Kaiji Zhang 1 & Ying Lian 1 & Xiaohong Guan 1 & Qian Hu 1 & Lihua Lei 1 & Li Tao 1 & Dong He 1 & Juan Lin 1 & Zheng Hou 1 & Lirong Ren 1 & Xiaoxiao Liu 1 & Qian Ren 1 & Lin Pan 1 & Xiaoli Fei 1 & Mei Xiong 1 & Shunzhu Wen 1 & Jinzhu Cao 1 Received: 18 May 2020 / Accepted: 7 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Decitabine is a hypomethylating drug that is used to treat myelodysplastic syndrome (MDS) at a recommended dose and schedule (20 mg/m2 per day, for 5 consecutive days). However, due to its relatively high incidence of side effects and its effects on neoplastic cells, many studies have begun to explore the clinical application of a low dose of decitabine for treating MDS. In this retrospective study, we examined the effects of a very-low-dose decitabine schedule for treating MDS. A total of 13 patients diagnosed with de novo MDS received a schedule of intravenous decitabine administration at 6 mg/m2 per day for 7 days, repeated every 4 weeks. The complete response rate was 30.8%, and the overall response rate was 69.2%. In patients with complete remission, the median time to granulocyte recovery greater than 0.5 × 109/L during complete remission (CR) was 15 days. In patients with remission, the median time to granulocyte recovery greater than 0.5 × 109/L was 10.5 days. The 1-year survival rate was 72.7% and the median survival was 28.0 months. In summary, we demonstrated that a very-low-dose decitabine schedule has an appreciable response and survival rate, as well as appreciable tolerance and medical compliance for treating MDS. Keywords Myelodysplastic syndrome . Hypomethylating drugs . Decitabine . Very low dose
Introduction Myelodysplastic syndrome (MDS) is a group of blood cancers characterized by immature blood cells in the bone marrow (BM) that have an impaired capacity to become healthy mature blood cells. In MDS, clonal hematopoietic stem cells with characteristics of cytopenia and ineffective hematopoiesis are risk factors of developing acute myeloid leukemia (AML) [1, 2]. The vast majority of patients with MDS are elderly, with a median age of 71 years for males and 75 for females at disease diagnosis [3]. At present, the main treatments for MDS include allogeneic stem cell transplantation, hypomethylating agents (HMAs), and chemotherapy. Among these therapeutic strategies, allogeneic stem cell transplantation is regarded as
* Kaiji Zhang [email protected] 1
Department of Hematology, Chengdu First People’s Hospital, Chengdu 610041, Sichuan Province, China
the only curative therapy, and intensive chemotherapy is not applicable for most patients due to age and poor physical condition. Therefore, HMA treatment, low-dose chemotherapy, and best supportive care are the remaining options for most patients. Two HMAs, azacitidine and decitabine, have been shown to have superior response and
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