Therapeutic effects and safety of HAG combined with decitabine on myelodysplastic syndrome

doi:10.3969/j.issn.1002-7386.2017.15.003

Abstract：Objective To investigate the therapeutic effects of homoharringtonine+aracytidine+granulocyte colony-stimulating factor (HAG) combined with decitabine on myelodysplastic syndrome, and to evaluate its safety.Methods Eighty-six patients with myelodysplastic syndrome were randomly divided into HAG group and combination treatment group,with 43 patients in each group.The patients in HAG group were treated with homoharringtonine by intravenous drip, 1mg/d, 1 time/d, aracytidine by intravenous drip,2mg/kg,1 time/d,granulocyte colony-stimulating factor by intravenous drip,300g/d,1 time/d, for 14 days.However,the patients in combination treatment group,on the basis of HAG group,were treated with decitabine by intravenous infusion, 15mg/m2,continuous infusion for 3 hours or more,1 time/8 hours,for 3 days.The changes of vascular endothelial growth factor, white blood cell,platelet and hemoglobin levels were observed before and after treatment,moreover, the incidence rate of adverse reactions and relapse rate were observed and compared between two groups.The patients in both group were followed up until January 2016,and the overall survival time and disease free survival time were observed,besides, the survival curve was drawn.Results After treatment the levels of vascular endothelial growth factor,white blood cell,platelet and hemoglobin in both groups were significantly higher than that before treatment,moreover, which in combination treatment group were significantly higher than those in HAG group (P<0.05).The therapeutic effects in combination treatment group were superior to those of HAG group (U=2.118,P<0.05).The complete remission rate and total effective rate in combination treatment group were significantly higher than those in HAG group (P<0.05).However there were no significant differences in the incidence rates of thrombocytopenia,diarrhea,liver function injury between two groups (P>0.05).After follow-up till January 2016,14 patients died in HAG group, however,only 6 patients died in combination treatment group.Moreover the overall survival time and disease-free survival time in combination treatment group were significantly higher than those in HAG group (P<0.05).Conclusion The HAG combined with decitabine in treatment of myelodysplastic syndrome can significantly improve the levels of vascular endothelial growth factor and related blood cells,prolong the survival time of patients,reduce death rate,with obvious clinical effects.