The Treatment Of The Myelodysplastic Syndrome With TADA Or Decitabine Retrospective Analysis

Objective:To compare the clinical efficacy and adverse reactions of thalidomide,arsenic trioxide(ATO),dexamethasone and ascorbic acid(AA)combined therapy(TADA)~[and Decitabine(DAC)in the treatment of Myelodysplastic syndrome(MDS)patients,and to analyze the different factors affecting the survival time of patients.Method:Choose between January 2012 and December 2020,receive treatment in yanbian hospitaldepartment of Hematology for the first time in patients with MDS,divided into TADA and DAC group,among which patients need to accept 24 weeks TADA standardized treatment,DAC group of patients need to accept more than 4 treatments with decitabine monotherapy may include the conditions of observation.SPSS26.0 software was used to statistically analyze the clinical features,treatment effects,progression-free survival,overall survival,adverse reactions, etc.between the two groups of patients,and P<0.05 was difference was statistically significant.Results:1,A total of 55 patients with MDS who were initially treated were included in this study,including 20 patients in the TADA group,35 patients in DAC group,There was no statistical significance in the general clinical characteristics of 2groups(P>0.05).2,After standard treatment,the complete response rate(CR)30.0%,partial response rate(PR)15.0%and hematological improvement rate(HI)20.0%of MDS patients in TADA group,and the Overall response rate(ORR)=CR+PR+HI=65%.DAC group CR31.4%,PR11.4%,HI8.6%,ORR 51.4%;PR,HI and ORR in TADA group were higher than those in DAC group,but there was no statistical significance in CR,PR,HI and ORR between the two groups(P>0.05).3,After treatment,5 kinds of blood cells were decreased,and both drugs could cause myelosuppression,with statistical significance(P<0.05).RBC and hemoglobin in both groups reached the lowest point on the 14th day,and the inhibition degree in TADA group was lower than that in DAC group,with statistical significance(P<0.05);The lowest levels of white blood cells and neutrophil count were found in TADA group at 7 days after chemotherapy,and in DAC group at 14days after chemotherapy,with statistical significance(P<0.05).The lowest platelet level in TADA group was 21 days after chemotherapy,and that in DAC group was 14days after chemotherapy,with statistically significant differences between time periods(P<0.05).4,TADA after treatment group of 7 people appear edema,DAC group 3 people appear edema,statistically significant difference(P<0.05),TADA group 1person had a digestive system reaction,DAC group of 18 people,statistically significant difference(P<0.05),TADA group of 10 people needed a blood transfusion treatment,DAC group of 32 people,statistically significant difference(P<0.05),TADA group of 6 people need to use antibiotics,DAC group of 21 people,statistically significant difference(P<0.05).5,By December 31,2020 after treatment,19 patients in the TADA group and 27 patients in the DAC group died.TADA group of patients with a median Progression free survival(PFS)10 months and the median overall survival(OS)19months,the median PFS DAC group 8 months and the median OS 15 months,there were no statistically significant difference(P>0.05),at the end of the follow-up from diagnosis to analysis influence the single factor analysis of two groups of patients with MDS OS TADA and DAC group patients’gender,age,nationality,peripheral blood like before treatment(WBC,NE,RBC,Hb,PLT),Marrow blast differences had no statistical significance(P>0.05);Among the overall MDS patients,the influence of hemoglobin count before chemotherapy on patients’OS was statistically significant(P<0.05).Conclusion:Compared with DAC monotherapy in the treatment of myelodysplastic syndrome,the clinical efficacy of TADA combined therapy was similar,the degree of myelodysplastic depression after TADA therapy was relatively mild,and hemoglobin is an important factor affecting the OS of patients with MDS.