Analysis Of The Efficacy And Safety Of Azacytidine In The Treatment Of MDS Patients In High-risk Group

Objective To analyze the efficacy and safety of azacytidine in the treatment of patients with myelodysplastic syndrome in high-risk group,and to explore the possible influencing factors of efficacy and prognosis,so as to provide a theoretical basis for the follow-up clinical selection of azacytidine in the treatment of MDS in high-risk group.Methods A retrospective analysis was made of the higher-risk group of MDS patients admitted to the second affiliated Hospital of Anhui Medical University from February 2018 to January 2021.Among them,23 patients were treated with cytidine azacytidine alone,the specific dose was 75mg/m2,continuous use for 7 days as a course of treatment,28 days as a treatment cycle.The general data of 23 patients with MDS were collected and recorded,and the clinical efficacy,safety and survival time of each patient were analyzed and evaluated.Finally,the efficacy and survival time of the patients were statistically analyzed in terms of sex,age,previous treatment,percentage of bone marrow primordial cells before treatment,complex karyotype,bad gene mutation,granulocyte count before treatment,hemoglobin count,platelet count and total course of treatment.whether there are statistical differences between different clinical characteristics,to explore the possible influencing factors of efficacy and prognosis.Results(1)Among the 23 patients in the high-risk group,6 patients were stable,2patients had bone marrow complete remission with hematological improvement,5patients had bone marrow complete remission,and no patients achieved complete or partial remission.Treatment failed in 10 patients,including 1 patient with acute myeloid leukemia,3 patients with more progressive MDS subtype,and 6 patients died of uncontrollable severe infection or severe bleeding.The total effective rate of all patients was 56.5%(13 / 23),and the total effective rate of patients who received 4courses or more of treatment was 81.8%(9 / 11).(2)Of the 23 patients,18 developed infectious fever during treatment.the most common cases were pulmonary infection,skin and soft tissue infection and urinary tract infection,5 cases of injection site redness and swelling,3 cases of constipation,4 cases of diarrhea,2 cases of abnormal liver function and 2 cases of transient cardiac dysfunction.(3)The overall survival time of 23 patients was 0.2 to 26 months,the median survival time was 5 months,and the average survival time was 8 months.(4)In the higher risk group,the clinical efficacy and survival time of MDS patients treated with azacytidine were related to the age,previous treatment and the total number of courses received(p < 0.05).There was no significant difference in sex,percentage of bone marrow primordial cells before treatment,complex karyotype,bad gene mutation,granulocyte count,hemoglobin count and platelet count before treatment.Conclusion Azacytidine has a good efficacy in the treatment of MDS patients in high-risk group,which is suitable for patients who are unable to undergo stem cell transplantation.its efficacy and prognosis are mainly related to age,previous treatment and the total number of courses of treatment,while the adverse reactions are relatively simple and predictable,applicable to a wide range of people.