Clinical Efficacy and Safety of Decitabine in Treatment of 37 Cases of Myelodysplastic Syndrome

Objective To discuss the clinical efficacy and safety of an standard dosage of decitabine in the treatment of patients with myelodysplastic syndromes. Methods Totally 37 cases of MDS patients received the treatment of standard dose of decitabine, (20 mg/m2 each day, 5 days continued, each four weeks is a course of treatment) , which admitted in Hematology department of the First Affiliated Hospital of Kunming Medical University from January 2014 to December 2016. According to the established therapeutic regimen, collecting treatment effects and safety parameters of patients, and according to different groups factors to analyze the difference of effects. Results Twenty patients (54.1%) obtained the clinical effect after the treatment of decitabineafter at least 4 courses. There were 3 cases (8.10%) with complete remission (CR) , marrow CR (m CR) without hematological improvement (HI) in 6 cases (16.2%) , m CR with HI in 3 cases (8.1%) , and HI alone in 8 cases (21.6%) ; 3 cases (8.1%) achieved transfusion independence, and 11 cases (29.7%) with stable disease (SD) and 3 cases (8.1%) with progressive disease (PD) . The total response rate of MDS was calculated according to the patient age, WHO type and prognosis risk stratification, decitabine treatment of 65 patients under the age of ORR above, more than 65 patients of/RAEB RAEB-1-2 type ORR is higher than other types of patient, but the difference was not statistically significant (The 2 values were 0.815 and 1.213, P>0.05) . The ORR of patients with high risk group of IPSS prognostic risk score was significantly better than that of low-risk group, the difference was statistically significant (χ2=4.063, P=0.044) .The ORR of the high-risk group of WPSS prognosis was significantly better than that of the lower risk group, the difference was statistically significant (χ2=4.375, P=0.036) .Adverse reactions were most commonly seen in Blood platelet count decreased, white blood cell count decreased and medium granulocyte count decreased. Thehighest incidence of platelet count decreased, white blood cell count decreased and medium granulocyte count decreased that was found in 3 ~ 4 adverse reactions. The incidence rate was 65.5%, 59.3% and 53.8% respectively. Non-hematological adverse reactions mainly include infection, ALT, diarrhea and rashes, and most grades are given priority to 1 ~ 2 level. Conclusion Decitabine for treatment of MDS is well tolerated, and the adverse reactions occur reasonably and controllable, it can achieve the expected curative effect.