| Objective To assess the clinical efficacy and safety of Demethylation agents and best supportive care (BSC)in treating with Myelodysplastic syndromes.Methods Search the databases such as PubMed(1973-2013),embase(1998-2013), web of knowledge(1973-2013) , Cochrane library (1976-2013) and CNKI(1983-2013) , CQVIP(1989-2013), Wanfang database(1995-2013) and CBM(2008-2013) before March 2013. The randomized controlled trials (RCTs) on demethylation agents for MDS were involved. The methodological quality of the included studies was assessed according to the Cochrane Reviewer’s Handbook, and meta-analyses were performed using RevMan 5.1 softwareResults A total of 4 RCTs involving 816 patients were finally included.The results of meta-analysis showed that: Compared with the control group,Demethylation agents can improve the complete remission(CR)(OR=19.14,95%CI5.33 to 68.7),P<0.00001), partial remission(PR) (OR=20.63,95%CI 5.76 to 73.93,P<0.00001), hematologic improvemen(HI) (OR=3.58,95%CI 2.40 to 5.34,P<0.00001),grade Ⅲ/Ⅳ neutropenia(OR=3.82,95%CI 2.67 to 5.47 ,P<0.00001),grade Ⅲ/Ⅳ thrombocytopenia (OR=3.98,95%CI 2.55 to 6.23,P<0.00001),death rate(OR=0.52,95%CI 0.35 to 0.77,P<0.00001),The transformation time to AML and overall survival time were obviously prolonged in compared with the control group.There were no significant adverse reaction during the treatment.Conclusion The demethylation agents can significantly improve the overall response rate (complete remission, partial remission, hematological improvement) and prolonged the time of transformation time to AML, decrease the death rate and improve the quality of life. Meanwhile, it sometimes increases the incidence of Grade Ⅲ or Ⅳ events, such as neutropenia, thrombocytopenia, and other non-hematological adverse events... |
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