The efficacy and safety of the patients of myelodysplastic syndromes-refractory anemia with excess blasts treated with decitabine alone or CAG/HAG regimen
10.3760/cma.j.issn.0253-2727.2017.07.004
- VernacularTitle: 地西他滨单药与CAG/HAG方案治疗难治性贫血伴有原始细胞增多的疗效和安全性比较
- Author:
Zefeng XU
1
;
Tiejun QIN
;
Hongli ZHANG
;
Liwei FANG
;
Yue ZHANG
;
Lijuan PAN
;
Naibo HU
;
Shiqiang QU
;
Bing LI
;
Zhijian XIAO
Author Information
1. Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, The State Key Laboratory of Experimental Hematology, Tianjin 300020, China
- Publication Type:Journal Article
- Keywords:
Myelodysplastic syndromes;
Decitabine;
Antineoplastic combined chemotherapy protocols;
Treatment outcome;
Drug toxicity
- From:
Chinese Journal of Hematology
2017;38(7):572-577
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical efficacy and safety of the patients of myelodysplastic syndromes-refractory anemia with excess blasts (MDS-REAB) treated with decitabine alone or based on low dose cytarabine (Ara-C) regimen CAG/HAG [aclarubrci (ACR) /homoharring-tonine (HHT) +cytarabine+granulocyte colony stimulating factor (G-CSF) ].
Methods:Totally 121 patients with MDS-REAB were retrospectively analyzed, including 59 patients treated with decitabine alone (20 mg·m-2·d-1 for 5 days) , the rest 62 ones treated with low-dose Ara-C-based regimen CAG/HAG. Overall response rate (ORR) , overall survival (OS) and adverse events of the two groups were analyzed and compared retrospectively.
Results:The ORR of decitabine alone or CAG/HAG were 66.2% and 56.4% respectively, with no statistically significant differences (χ2=1.185, P=0.276) . Initial response rate detected by the end of first cycle of CAG/HAG was higher than that of decitabine alone (94.3% vs 69.2%) , there was statistically significant difference in the overall comparison of two groups (χ2=7.612, P=0.009) . The median OS of decitabine alone was 19.5 (95% CI 10.5-28.4) months, the median OS of CAG/HAG was 20.3 (95% CI 10.7-29.9) months, with no statistically significant differences (χ2=0.004, P=0.947) . Grade 3-4 cytopenia and infection were the most prevalent adverses of two group patients. Grade 3-4 cytopenia rate of CAG/HAG was higher than that of decitabine alone (100.0% vs 64.4%, P<0.001) . The infection rate detected at third cycle of CAG/HAG was higher than that of decitabine alone (52.9% vs 15.2%, P=0.008) .
Conclusion:The efficacy of treating MDS-RAEB with decitabine alone or CAG/HAG was equivalent. CAG/HAG treatment came into effect faster, but decitabine alone treatment was safer.
