Li Xiao, Song Qiang, Chen Yu, Chang Chunkang, Wu Dong, Wu Lingyun, Su Jiying, Zhang Xi, Zhou Liyu, Song Luxi, Zhang Zheng, Xu Feng, Hou Ming
Department of Hematology, the Sixth People's Hospital affiliated with Shanghai Jiaotong University, Shanghai, China.
Department of Hematology, Qilu Hospital affiliated with Shandong University, Jinan, China.
PLoS One. 2014 Apr 18;9(4):e95473. doi: 10.1371/journal.pone.0095473. eCollection 2014.
Decitabine has been approved for the treatment of all subtypes of myelodysplastic syndrome (MDS). However, the optimal regimen for decitabine treatment is not well established. In this study, an observational, retrospective and multi-center analysis was performed to explore the decitabine schedule for the treatment of MDS. A total of 79 patients received reduced dosage decitabine treatment (15 mg/M2/day intravenously for five consecutive days every four weeks). Fifty-three out of the 79 patients were defined as intermediate-2/high risk by international prognostic scoring system (IPSS) risk category. 67.1% of MDS patients achieved treatment response including complete response (CR) (n = 23), Partial response (n = 1), marrow CR (mCR) with hematological improvement (HI) (n = 11), mCR without HI (n = 11) and HI alone (n = 7) with a median of 4 courses (range 1-11). The median overall survival (OS) was 18.0 months. The median OS was 22.0, 17.0 and 12.0 months in the patients with CR, those with other response, and those without response, respectively. In addition, this regimen contributed to zero therapy-related death and punctual course delivery, although III or IV grade of cytopenia was frequently observed. In conclusion, the 15 mg/M2/d×5 day decitabine regimen was effective and safe for Chinese MDS patients with IPSS score of 0.5 or higher.
地西他滨已被批准用于治疗骨髓增生异常综合征（MDS）的所有亚型。然而，地西他滨治疗的最佳方案尚未完全确立。在本研究中，我们进行了一项观察性、回顾性、多中心分析，以探索地西他滨治疗MDS的方案。共有79例患者接受了低剂量地西他滨治疗（每四周连续五天静脉注射15mg/M2/天）。79例患者中有53例根据国际预后评分系统（IPSS）风险分类被定义为中危-2/高危。67.1%的MDS患者获得了治疗反应，包括完全缓解（CR）（n = 23）、部分缓解（n = 1）、伴有血液学改善（HI）的骨髓CR（mCR）（n = 11）、不伴有HI的mCR（n = 11）和单纯HI（n = 7），中位疗程为4个疗程（范围1-11）。中位总生存期（OS）为18.0个月。CR患者、其他反应患者和无反应患者的中位OS分别为22.0个月、17.0个月和12.0个月。此外，尽管经常观察到III或IV级血细胞减少，但该方案导致零治疗相关死亡且疗程按时完成。总之，15mg/M2/d×5天的地西他滨方案对IPSS评分为0.5或更高的中国MDS患者有效且安全。
