a Department of Hematology, The First Affiliated Hospital, College of Medicine , Zhejiang University , Hangzhou , Zhejiang , China.
b Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine , Zhejiang University , Hangzhou , Zhejiang , China.
Leuk Lymphoma. 2019 Jul;60(7):1731-1739. doi: 10.1080/10428194.2018.1546853. Epub 2019 Jan 8.
We retrospectively studied 133 myelodysplastic syndrome patients receiving decitabine during January 2009 and September 2017. The dose of 15 mg/m/d ( = 83) and 20 mg/m/d ( = 50) had comparable overall response rates (ORR) (51.8% vs. 52.00%) and complete remission rate (CRR) (15.66% vs. 22.00%). The 15 mg/m/d group had a lower incidence of grade 3/4 neutropenia (60.24% vs. 88.00%, < .05) and thrombocytopenia (65.06% vs. 88.00%, < .05). The 15 mg/m/d group had a longer median overall survival (OS) (21.60 months vs. 15.23 months, = .02). The same results were seen in refractory anemia with excess blasts (RAEB) patients: The 15 mg/m/d group also had comparable ORR, CRR, decreased hematological toxicities and longer OS. Further analysis suggested that survival benefit of 15 mg/m/d group was mainly in those patients with lower risk stratification. In conclusion, 15 mg/m/d decitabine is associated with a lower incidence of hematological toxicities and longer OS and may be more suitable for patients with relatively lower risk.
我们回顾性研究了 2009 年 1 月至 2017 年 9 月期间接受地西他滨治疗的 133 例骨髓增生异常综合征患者。15mg/m/d（n=83）和 20mg/m/d（n=50）的剂量具有相当的总缓解率（ORR）（51.8% vs. 52.00%）和完全缓解率（CRR）（15.66% vs. 22.00%）。15mg/m/d 组的 3/4 级中性粒细胞减少症（60.24% vs. 88.00%，<.05）和血小板减少症（65.06% vs. 88.00%，<.05）发生率较低。15mg/m/d 组的中位总生存期（OS）（21.60 个月 vs. 15.23 个月，=.02）更长。在难治性贫血伴过多原始细胞（RAEB）患者中也观察到相同的结果：15mg/m/d 组的 ORR、CRR、血液学毒性降低和 OS 延长相当。进一步分析表明，15mg/m/d 组的生存获益主要见于风险分层较低的患者。总之，15mg/m/d 地西他滨与较低的血液学毒性发生率和更长的 OS 相关，可能更适合风险较低的患者。
