Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT 06520-8034, USA.
Leuk Res. 2011 Jul;35(7):904-8. doi: 10.1016/j.leukres.2010.10.007. Epub 2010 Nov 9.
Little is known about how hypomethylating agents (HMAs) have been adopted into the treatment of myelodysplastic syndromes (MDS). We conducted a population-based study to assess the use of HMAs among 4416 MDS patients (age≥66 years) who were diagnosed during 2001-2005 and followed up through the end of 2007. Multivariate logistic regression models were utilized to evaluate the role of various patient characteristics. 475 (10.8%) patients had received HMAs by 2007, with the proportion increasing over time. Patients who were white (odds ratio (OR)=0.66, 95% confidence interval (CI): 0.46-0.95), male (OR=1.47, 95% CI: 1.19-1.82), young (Ptrend<0.01), more recently diagnosed (OR=1.90, 95% CI: 1.54-2.34), had fewer comorbidities (Ptrend<0.01), or had a history of other cancer (OR=1.28, 95% CI: 1.00-1.63) were more likely to receive HMAs. Compared with patients with refractory anemia, those diagnosed with refractory anemia with excess blasts or refractory cytopenia with multilineage dysplasia had a higher chance to be treated with HMAs (OR=3.52 and 2.32, respectively). Relatively few MDS patients were treated with HMAs during the introduction period of these agents, and multiple patient characteristics such as sex, comorbidities, and MDS subtype influence the likelihood a patient receives HMAs.
关于低甲基化剂 (HMA) 如何被应用于骨髓增生异常综合征 (MDS) 的治疗，目前知之甚少。我们进行了一项基于人群的研究，以评估在 2001-2005 年间诊断出的 4416 名 MDS 患者（年龄≥66 岁）中，HMA 的使用情况，并随访至 2007 年底。多变量逻辑回归模型用于评估各种患者特征的作用。到 2007 年，有 475 名（10.8%）患者接受了 HMA 治疗，比例随时间增加。白人患者（比值比（OR）=0.66，95%置信区间（CI）：0.46-0.95）、男性（OR=1.47，95%CI：1.19-1.82）、年轻（Ptrend<0.01）、最近诊断（OR=1.90，95%CI：1.54-2.34）、合并症较少（Ptrend<0.01）或有其他癌症史（OR=1.28，95%CI：1.00-1.63）的患者更有可能接受 HMA 治疗。与难治性贫血患者相比，诊断为难治性贫血伴过多原始细胞或难治性血细胞减少伴多系发育异常的患者接受 HMA 治疗的可能性更高（OR=3.52 和 2.32）。在这些药物引入期间，相对较少的 MDS 患者接受 HMA 治疗，多种患者特征，如性别、合并症和 MDS 亚型，影响患者接受 HMA 的可能性。
