Comparison of the Curative Efficacy of Elderly Patients with High-Risk MDS and MDS-Transformed AML between Decitabine Combined with Low-Dose CEG Regimen and Decitabine Combined with Low-Dose CAG Regimen.
10.19746/j.cnki.issn.1009-2137.2020.06.032
- Author:
Min WU
1
;
Ie-Xian MA
1
;
Yan-Hui XIE
2
;
Xiu-Jin YE
3
;
He-Sheng HE
4
;
Jing-Sheng HUA
5
;
Ru-Yu YANG
6
;
Xiao-Hua WANG
7
;
Xiao-Qin WANG
8
;
Fei LI
9
Author Information
1. Department of Hematology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China.
2. Department of Hematology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China E-mail: yanhuixie@163.com.
3. Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
4. Department of Hematology, The First Affiliated Hospital of Anhui Southern Anhui Medical College, Wuhu 241001, Anhui Province, China.
5. Department of Hematology, Taizhou State Hospital, Taizhou 318000, Zhejiang Province, China.
6. Department of Hematology, Nanyang Central Hospital of Henan Province, Nanyang 473009, Henan Province, China.
7. Department of Hematology, Wuhu Second People's Hospital of Anhui Province, Wuhu 241000, Anhui Province, China.
8. Department of Hematology, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China.
9. Department of Hematology, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
- Publication Type:Randomized Controlled Trial
- MeSH:
Aclarubicin;
Aged;
Antineoplastic Combined Chemotherapy Protocols;
Azacitidine/therapeutic use*;
Cytarabine/therapeutic use*;
Decitabine/therapeutic use*;
Granulocyte Colony-Stimulating Factor;
Humans;
Leukemia, Myeloid, Acute/drug therapy*;
Myelodysplastic Syndromes/drug therapy*;
Patients;
Prospective Studies;
Treatment Outcome
- From:
Journal of Experimental Hematology
2020;28(6):1991-1997
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the efficacy of decitabine combined with low-dose CEG regimen (DCEG) and decitabine combined with low-dose CAG regimen (DCAG) in the treatment of elderly patients with MDS and MDS-transformed acute myeloid leukemia (AML).
METHODS:A prospective study was conducted in 7 medical centers, 45 patients with MDS (≥ 60 years old) and MDS-transformed AML from October 2016 to January 2019 were enrolled, with the median age of 68.5 years old. The risk stratification of patients was poor or very poor, according to IPSS-R score. The treament results of decitabine combined with CEG and decitabine combined with CAG were compared.
RESULTS:The comparison of the two regiem showed that the DCEG regimen had advantages on total effective rate (ORR, 86.4% vs 47.8%, respectively), overall survival time (OS) (10.0 months vs 6.0 months, respectively) and progression-free survival time (PFS) (9.0 months vs 3.0 months, respectively). About 50% of MDS patients treated by DCEG regimen achieved PR or CR, with a median OS of 31 months. Multivariate analysis showed that patients with PR or CR after induction therapy and DCEG regimen had longer survival time (31months). The incidence of bone marrow suppression, infection and treatment-related mortality rate were similar between the two groups.
CONCLUSION:Decitabine combined with CEG regimen could improve the survival of patients with high-risk MDS and MDS-transformed AML. The conclusion of the reaserch needs to be validated by a larger prospective randomized clinical trial.
