Very-Low-Dose Decitabine Is Effective in Treating Intermediate- or High-Risk Myelodysplastic Syndrome.

Abstract

Nowadays, the regular recommended dose of decitabine for the treatment of myelodysplastic syndrome (MDS) is 20 mg/m2/day for 5 consecutive days with a relatively high incidence of treatment-related morbidities and costs. In this study, a retrospective and multicenter analysis was performed to explore the very-low-dose decitabine schedule for the treatment of patients with IPSS intermediate- or high-risk MDS. A total of 31 newly diagnosed MDS cases from 14 hospitals in Beijing received decitabine monotherapy (decitabine 6 mg/m2/day intravenously for 7 consecutive days, repeated every 4 weeks). With a medium follow-up of 4 months, 10 patients achieved complete remission (32.3%), 8 (25.8%) partial remission, and 3 (9.7%) hematological improvement. The overall response rate (ORR) was 67.7%. Rates of 21.7% for severe infections and 11.6% for severe bleedings were observed among all courses. The median cost of each course was USD 5,300, 3,000, 2,900, and 2,000, respectively. Multivariate analysis identified bone marrow blast cells ≥10% and a Charlson comorbidity index ≥1 as 2 independent factors for efficacy. In conclusion, very-low-dose decitabine showed relatively good efficacy, good tolerance, and low medical cost in the treatment of intermediate- or high-risk MDS. Elderly patients with more than 1 complication or patients with a higher proportion of blast cells may be the most suitable candidates for this regimen.

• Authors: Hongmin Li, Liru Wang, Yue Wu, Li Su, Hong Zhao, Yongqing Zhang, Zhao Wang, Dayong Huang, Zhongxia Huang, Xiaoxiong Wu, Xiaohong Li, Fang Ye, Fan Yu, Hui Liu, Jing-Wen Wang, Jia Cong, Wanjun Sun, Hui-Ren Chen, Jingbo Wang, Bing Han
• Journal: Acta haematologica (Acta Haematol) 2017 Vol. 138 Issue 3 Pg. 168-174 ISSN: 1421-9662 [Electronic] Switzerland
• PMID: 29045939 (Publication Type: Journal Article)
• Copyright: © 2017 S. Karger AG, Basel.

Chemical References

• Antimetabolites, Antineoplastic
• DNA-Binding Proteins
• Proto-Oncogene Proteins
• Decitabine
• Dioxygenases
• TET2 protein, human
• Azacitidine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (adverse effects, therapeutic use)
• Azacitidine (adverse effects, analogs & derivatives, therapeutic use)
• Costs and Cost Analysis
• DNA-Binding Proteins (genetics)
• Decitabine
• Dioxygenases
• Female
• Hemorrhage (etiology)
• Humans
• Injections, Intravenous
• Male
• Middle Aged
• Multivariate Analysis
• Myelodysplastic Syndromes (diagnosis, drug therapy, economics)
• Polymorphism, Genetic
• Proto-Oncogene Proteins (genetics)
• Retrospective Studies
• Risk
• Treatment Outcome