回顾性分析地西他滨治疗骨髓增生异常综合征患者的基线骨髓原始细胞比例与反应率和总生存率相关的预后因素。
Retrospective analysis of prognostic factors associated with response and overall survival by baseline marrow blast percentage in patients with myelodysplastic syndromes treated with decitabine.
机构信息
The University of Texas MD Anderson Cancer Center, Houston, TX.
出版信息
Clin Lymphoma Myeloma Leuk. 2013 Oct;13(5):592-6. doi: 10.1016/j.clml.2013.05.004. Epub 2013 Jun 20.
BACKGROUND
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.
PATIENTS AND METHODS
Outcomes for patients with myelodysplastic syndrome (MDS) with baseline marrow blasts ≥ 20% and < 30% (RAEB-t group) and < 20% (MDS group) were compared.
RESULTS
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.
CONCLUSION
Decitabine is active in and may benefit patients with > 20% blasts (RAEB-t).
背景
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。
患者和方法
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。
结果
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。
结论
地西他滨对>20%原始细胞（RAEB-t）有效，可能对其有益。
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