Efficacy of Decitabine Combined with Pre-Excitation Chemotherapy in the Treatment of Middle-Aged and Elderly MDS Transformed Acute Myeloid Leukemia.
10.7534/j.issn.1009-2137.2018.06.022
- Author:
Zhang-Kun LI
1
;
Ying-Chang LAI
1
;
Kun LI
1
;
Ji-Xiang HE
1
;
Yi-Rong JIANG
2
;
Shu-Yang LIU
3
Author Information
1. Department of Hematology, The People's Hospital of Dongguan City, Dongguan 523059, Guangdong Province, China.
2. Department of Hematology, The People's Hospital of Dongguan City, Dongguan 523059, Guangdong Province, China.E-mail: dgjyr0769@163.com.
3. Department of Internal Medicine, The People's Hospital of Renhua County, Shaoguan 512300, Guangdong Province, China.
- Publication Type:Journal Article
- MeSH:
Aged;
Antineoplastic Combined Chemotherapy Protocols;
therapeutic use;
Decitabine;
administration & dosage;
Humans;
Leukemia, Myeloid, Acute;
drug therapy;
Middle Aged;
Myelodysplastic Syndromes;
Prognosis
- From:
Journal of Experimental Hematology
2018;26(6):1713-1718
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the efficacy of domestic decitabine (D) combined with pre-excitation chemotherapy consisted of Ara-c, THP and G-CSF(CTG) in treatment of middle-aged and elderly patients with MDS-transformed AML and prognosis-related factors.
METHODS:Seventy-six patients with MDS-transformed AML treated in our hospital from June 2013 to June 2015 were selected according to treatment regimens, 76 patients were divided into 2 groups: CTG group(36 cases) and D+CTG group(40 cases). The patients in CTG group received treatment with Ara-C, THP and G-CSF; the patients received the treatment with decitabine plus CTG. The patients in 2 groups all received 4 course treatment, then received maintaining treatment. The therapeutic efficacy and incidence of adverse reactions in 2 group were compared, at the same time, the risk factors affecting the prognos of patients treated with D+CTG were analyzed.
RESULTS:There were no siginificant differences in age, sex, initial blood cell count, bone marrow blast ratio, disease types, chromosome karyotypes and FLT3-ITD gene mutation between 2 groups. The efficacy analysis showed that the efficacy of D+CTG was superior to CTG, ORR in D+CTG group was significantly higher than that in CTG group (72、52 vs 50%) (P<0.05), moreover, no significant differences in bone marrow inhibition digree infeetion, gastroinfestinal response and liver damage were found between 2 groups (P>0.05). The follow-np for 2 years showed that the median survival time in D+CTG group was significantly longer than that in CTG group (19.9 vs 11.0 months) (P<0.05). The multivariate analysis showed that the 1 course efficacy (RR=3.926, P=0.015) and FLT3-ITD gene mutation (RR=4.347, P=0.004) were independent risk factors affecting the efficacy of D+CTG treatment.
CONCLUSION:The short-and long-term efficacy of domestic decitasine combined with preexcitation chenotherapy in treatment of middec-aged and eldery patients with MDS transformed AML is superior to single pre-excitation chenothrapy, moreover the incidence of adverse reactions did not increase. The 1 course efficacy and FLT-3 ITD gene mutation are the independent risk factors affecting the prognosis of patients. .
