Initiatory Efficacy Of CAG Regimen,Decitabine Alone And Decitabine Combined With Half-dose CAG Regimen In Patients With Myelodysplastic Syndrome

Objective:To investigate and compare the initiatory efficacy and safety of CAG regimen(aclarubicin,Ara-C,and G-CSF),Decitabine(DAC)alone and DAC combined with half-dose CAG regimen in patients diagnosed with myelodysplastic syndrome(MDS).Methods:Clinical data of 38 newly diagnosed with MDS patients were collected.9,13 and 16 patients were treated with CAG regimen,DAC alone and DAC combined with half-dose CAG regimen,respectively.Initiatory efficacy and adverse events of these three groups are analyzed.Results:The three groups overall response rate(ORR)was 89.5%,including complete remission(CR)in 9 cases(23.7%),partial response(PR)in 2 cases(5.3%),marrow complete remission(m CR)in 15 cases(39.5%),hematologic improvement(HI)in 1case(2.6%).Moreover,7 cases(18.4%)received stable disease(SD),3 cases received progress,1 case was finally death.The ORR of CAG regimen was(44.4%),including CR in 2 cases(22.2%),m CR in 2 cases(22.2%).The ORR of DAC alone regimen was(77.0%),including CR in 2 cases(15.4%),PR in 2 cases(15.4%),m CR in 6cases(46.2%).The ORR of DAC combined with half-dose CAG regimen was(81.4%),including CR in 5 cases(31.3%),m CR in 7cases(43.8%),HI in 1 case(6.3%).The ORR and CR rate in the DAC combined with half-dose CAG group were superior to those in both DAC alone group and CAG regimen(81.4% vs 77.0% vs 44.4%,31.3 vs15.4% vs 22.2%,respectively),however,the difference between the three groups was not statistically significant(P=0.127 and P=0.603,respectively).Bone marrow suppression and infections were the major adverse reactions,however,the difference between the three groups was not statistically significant(P=0.9 and P=0.129,respectively).Conclusion: CAG regimen,DAC alone and DAC combined with half-dose CAG regimens are effective in patients diagnosed with intermediate to high-risk MDS.The ORR and CR rate in the DAC combined with half-dose CAG group were superior to those in both DAC alone group and CAG regimen(81.4% vs 77.0% vs 44.4%,31.3 vs 15.4% vs 22.2%,respectively),however,the difference between the three groups was not statistically significant(P=0.127 and P=0.603,respectively).Bone marrow suppression and infections were the major adverse reactions,most patients can tolerate these adverse reactions.The difference in survival between three regimens still needs further observation.