The University of Texas MD Anderson Cancer Center, Houston, TX.
Clin Lymphoma Myeloma Leuk. 2013 Oct;13(5):592-6. doi: 10.1016/j.clml.2013.05.004. Epub 2013 Jun 20.
After the World Health Organization (WHO) changed the definition of acute myeloid leukemia (AML) to ≥ 20% blasts, the International Working Group (IWG) response criteria for myelodysplasia were updated. This retrospective analysis evaluated response to decitabine using updated IWG criteria in patients pooled from 2 decitabine trials.
Outcomes for patients with myelodysplastic syndrome (MDS) with baseline marrow blasts ≥ 20% and < 30% (RAEB-t group) and < 20% (MDS group) were compared.
Patients with RAEB-t (n = 26) had a significantly shorter time from diagnosis to study treatment (7.3 vs. 18.3 months), a higher International Prognostic Scoring System (IPSS) risk (77% vs. 16% high-risk patients), and lower median baseline platelet count (62.3 vs. 112.7 × 10(3)/μL) vs. patients with MDS (n = 157), yet no significant difference in overall response rate (ORR) (15.4% vs. 28.0%). Patients with MDS had better duration of response (9.9 vs. 5 months; P = .024) and overall survival (OS) (16.6 vs. 9.0 months; P = .021) compared with patients with RAEB-t.
Decitabine is active in and may benefit patients with > 20% blasts (RAEB-t).
世界卫生组织（WHO）将急性髓系白血病（AML）的定义修改为≥20%的原始细胞后，国际工作组（IWG）对骨髓增生异常综合征（MDS）的反应标准进行了更新。本回顾性分析采用更新后的 IWG 标准评估了在来自 2 项地西他滨试验的患者中地西他滨的反应。
比较了基线骨髓原始细胞≥20%且<30%（RAEB-t 组）和<20%（MDS 组）的 MDS 患者的结局。
RAEB-t 组（n=26）患者从诊断到研究治疗的时间明显缩短（7.3 个月 vs. 18.3 个月），国际预后评分系统（IPSS）风险较高（77% vs. 16%的高危患者），且基线血小板计数中位数较低（62.3 vs. 112.7×103/μL），而与 MDS 患者（n=157）相比，总体反应率（ORR）无显著差异（15.4% vs. 28.0%）。MDS 患者的反应持续时间（9.9 个月 vs. 5 个月；P=0.024）和总生存（OS）（16.6 个月 vs. 9.0 个月；P=0.021）均优于 RAEB-t 患者。
地西他滨对>20%原始细胞（RAEB-t）有效，可能对其有益。
