Clinical Analysis Of Decitabine Combined With Chemotherapy On Treatment Of Myelodysplastic Syndromes Refracrory Aremia With An Excess Of Blast

Objective We aimed to investigate weather decitabine combined with chemotherapy could improve the outcome of patients MDS-RAEB.Methods This study included 68 patients with MDS-RAEB from January,1,2012 to December,31,2017 in Wuxi people’s Hospital Affiliated to Nanjing Medical University.Among them,29 received the treatment of chemotherapeutic regimens of itecitabine combined with chemotherapy,5 received the treatment of single agent of di citabine,and 34 received comprehensive treatment.The baseline data of age,sex and chromosome karyotype were recorded,and the efficacy,side effects and prognosis of MDS-RAEB were analyzed.Results The median survival time of all 68 patients was 8 months(1-60 months).The overall efficacy of the patients in the combined chemotherapy group was significantly better than that of the chemotherapy group(ORR:79.3%vs44.1%,P=0.012;CR:58.6vs26.5%,P=0.01).The incidence of infection in the two groups was significantly higher than that in the combination chemotherapy group(58.6%vs85.3%,P=0.008),but the incidence of gastrointestinal reaction was significantly lower than that of the seabine combined chemotherapy group(41.2%vs65.5%,P=0.047),and the other adverse reaction rates in the two groups,such as anemia and granulocytic reduction,were observed.There was no significant difference in thrombocytopenia and liver dysfunction(P= 0.058,0.315,0.594,0.454).The median survival time of the two groups of patients was compared to those in the chemotherapy group(P=0.044,11 months vs 6months).Further subgroup analysis,for patients older than 60 years old,the total survival time of thesahitabine combined chemotherapy group was better than that of the chemotherapy group(14 months vs 6months,P=0.002);for the IPSS group as middle and low risk patients,the total survival time of the combined chemotherapy group was better than that of the chemotherapy group(11months vs 5months,P=0.021,).The median survival time for the two groups of patients with complete remission compared to those with no remission after treatment was longer,and there was no significant difference in the median survival time for the two groups(P =0.12,0.076)for patients younger than 60 years of age and IPSS groups as high-risk groups.Conclusion The combination of deitabine and chemotherapy is effevtive and well tolarated in patients with MDS-RAEB.It is worthy of further promotion and application.