Comparison Of The Protocol Including Decitabine Or Not In Treatment Of Myelodysplastic Syndromes In Adults

【Background】Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoieticstem cell disorders, mostly in elderly patients,MDS is characterized by an increasedbut ineffective and dysplastic hematopoiesis as well as peripheral cytopenias.RAEB-1and REAB-2, which characterized in raised blasts,representing one-third of the totalpatients of MDS, result in a significantly increased risk of progression to acutemyeloid leukemia.Traditional treatment methods commonly used chemotherapy ofacute myeloid leukemia.Aberrant DNA methylation frequently exist in malignanthematological disease.Demethylation treatment has become an another important wayfor the malignant hematologic desease,which many genes such as alcitoni、SHP-1、MST1、P16、P73、MLH1、P15、RARβ、DAPK、CDH1、ER、NES1、SYK-1、ASPP-1、 sFRP-2、 sFRP-2、 sFRP-5were detected different degrees ofhypermethylation in malignant hematological disease including leukemia, Decitabineis a DNA Methylation transferase inhibitor, is widely used clinically significantlyimproved after treatment and prognosis of MDS.However，differences in the efficacyof the two protocol are no clear conclusion at home and abroad.【Objective】To investigate the efficacy and toxicity of treatment including decitabine or notas therapy in adult patients with newly diagnosed myelodysplastic syndromes.【Methods】Retrospectively analyzing the clinical data of82adult patients with MDS whichwere newly diagnosed from January1,2008to August30,2013in Fujian MedicalUniversity Union Hospital.33patients were treated with protocol including Decibineand49patients received Traditional treatment.Efficacy and toxicity analysis werecompared between the two groups.【Results】The responses with decitabine group versus the control group, respectively, were as follows: complete response(12.1%v6.12%), partial response (15.2%v0%),hematologic improvement (15%v10.2%), the overall response rate (27.3%v6.12%).Among those,ORR and PR was statistically significant in the casegroup(P<0.05). The median overall survival were respectively24(1-61) months in thecase group and22(1-54) months in the control group, PFS was respectively15m and14m,the difference not was significant (P>0.05).【Conclusion】DAC group has a higher ORR rate, longer OS than traditional group for thetreatment of newly diagnosed MDS, and the two groups have no significant differencebetween toxicity. It is considered that decitabine has a better efficacy compared withtraditional treatment. Long-term effects need further observation.