Jiale Ma, Yan Wang, L. Xiang, Luqun Wang, Jie Fu, Pu Zhang, Xiao-Ling Li
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The median course of treatment to achieve the best effect was 3.5 (3-4) courses. With a median follow-up of 14 (2-68) months, 63 patients had a overall survival rate (OS) of 84.2% and a 1-year progression-free survival rate (PFS) of 73%. In univariate analysis, the factors that prolonged OS were that the best effect after medication was stable disease (SD) (to achieve complete remission, partial remission, complete bone marrow remission, hematological improvement) (P=0.009) and no thrombocytopenia at first diagnosis (P=0.019), the factor that prolongs PFS is the best effect above SD (P=0.003). Multivariate analysis suggested that the factors affecting OS and PFS were the best curative effects above SD (P=0.015 vs P=0.008). The adverse effects of decitabine in the treatment of MDS-RAEB were mainly bone marrow suppression and pulmonary infection. \n \n \nConclusions \nDecitabine is an effective and well-tolerated drug in the treatment of MDS-RAEB. 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引用次数: 0
摘要
目的分析地西他滨(DAC)治疗骨髓增生异常综合征难治性贫血伴原细胞过多(MDS-RAEB)的临床疗效、安全性及影响因素。方法回顾性分析63例经DAC治疗的MDS-RAEB患者的临床疗效及不良反应，分析影响患者生存的因素。结果63例患者中RAEB-1阳性23例，RAEB-2阳性40例。中位疗程为4(2-13)个疗程。DAC治疗MDS-RAEB的总有效率为58.7%(37/63)，完全缓解率为20.6%(13/63)。37例有效患者中，20例(54.1%)在2个疗程后有效。达到最佳效果的中位疗程为3.5(3-4)个疗程。中位随访14(2-68)个月，63例患者总生存率(OS)为84.2%，1年无进展生存率(PFS)为73%。单因素分析中延长OS的因素为用药后病情稳定(SD)(达到完全缓解、部分缓解、骨髓完全缓解、血液学改善)(P=0.009)和初诊无血小板减少(P=0.019)，延长PFS的因素为SD以上效果最佳(P=0.003)。多因素分析显示，影响OS和PFS的因素在SD以上疗效最佳(P=0.015 vs P=0.008)。地西他滨治疗MDS-RAEB的不良反应主要为骨髓抑制和肺部感染。结论地西他滨是治疗MDS-RAEB有效且耐受性良好的药物。地西他滨治疗反应是影响预后的独立因素之一。关键词:贫血，难治性，原细胞过多;药物治疗、联合用药;Decitabine;预后;因子分析、统计学
Analysis on clinical efficacy and influencing factors of decitabine-based regimens in patients with myelodysplastic syndrome-refractory anemia with excess blasts
Objective
To analyze the clinical efficacy, safety and influencing factors of decitabine (DAC)-based regimens in patients with myelodysplastic syndrome-refractory anemia with excess blasts (MDS-RAEB).
Methods
We performed a retrospective analysis of 63 patients with MDS-RAEB treated with DAC, evaluated the clinical efficacy and adverse reactions, and analyzed the influencing factors affecting survival.
Results
Among 63 patients, 23 were RAEB-1 and 40 were RAEB-2. The median treatment was 4 (2-13) courses. The total effective rate of DAC for MDS-RAEB was 58.7%(37/63), and the complete response rate was 20.6%(13/63). Among 37 patients who were effective, 20 (54.1%) patients performed efficacy after 2 courses. The median course of treatment to achieve the best effect was 3.5 (3-4) courses. With a median follow-up of 14 (2-68) months, 63 patients had a overall survival rate (OS) of 84.2% and a 1-year progression-free survival rate (PFS) of 73%. In univariate analysis, the factors that prolonged OS were that the best effect after medication was stable disease (SD) (to achieve complete remission, partial remission, complete bone marrow remission, hematological improvement) (P=0.009) and no thrombocytopenia at first diagnosis (P=0.019), the factor that prolongs PFS is the best effect above SD (P=0.003). Multivariate analysis suggested that the factors affecting OS and PFS were the best curative effects above SD (P=0.015 vs P=0.008). The adverse effects of decitabine in the treatment of MDS-RAEB were mainly bone marrow suppression and pulmonary infection.
Conclusions
Decitabine is an effective and well-tolerated drug in the treatment of MDS-RAEB. Response to decitabine treatment is one of the independent factors affecting the prognosis.
Key words:
Anemia, refractory, with excess of blasts; Drug therapy, combination; Decitabine; Prognosis; Factor analysis, statistical
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