[Clinical Observation of Therapeutic Regimen Consisted of Decitabine Combined with Low-Dose IA Regimen for Myelodysplastic Syndrome-EB].

OBJECTIVE: To investigate the clinical efficacy of decitabine combined with low-dose IA for treating patients with myelodysplastic syndrome-EB.

METHODS: Thirty-seven cases of myelodysplastic syndrome-EB patients diagnosed in the First Affiliated Hospital of Xi'an Jiaotong University from June 2015 to January 2017 were analyzed retrospectively. These patients accepted DAC+IA(19 cases) and DAC(18 cases) treatment separately, and the differences of clinical efficacy between them were compared.

RESULTS: After 1-2 treatment cycles, in DAC+IA group the rate of complete remission with full hematologic recovery and incomplete hematologic recovery was 57.9%, and overall response rate was 100%. Immature cells level observed in bone marrow pathology was significantly decreased, compared with level before treatment. Peripheral blood neutrophil count, hemoglobin level and platelet count increased significantly. The median duration of the complete remission was 7.3 months. The progression free survival time was 10 months. Three patients with complete remission relapsed after interruption of treatment for 3.5 months. In DAC group complete remission rate was 16.7%, and overall response rate was 38.9%. The progression free survival lasted for 6 months. The median time of 3 complete remission patients transformed to AML was 4 months. The common adverse reactions were myelosuppression and infection without significant difference between the 2 groups.

CONCLUSION: The regimen of decitabine combinated with low-dose IA for treating patients with myelodysplastic syndrome-EB is effective, which can prolong the survival and improve the quality of life, whereas the long-term effect needs to be consolidated by allogeneic hematopoietic stem cell transplantation.