Clinical Efficacy of Low-dose Decitabine Combined with Cytarabine in the Treatment of Patients with Medium and High Risk MDS

SU Jie

doi:10.3969/j.issn.1002-3429.2018.03.024

Abstract：Objective To investigate clinical efficacy of low-dose Decitabine combined with Cytarabine in the treatment of medium and high risk myelodysplastic syndrome (MDS).Methods A total of 27 patients with medium and high risk MDS admitted to our hospital from January 2012 to January 2015 and treated with low-dose Decitabine (10 mg/d) + Cytarabine were enrolled as combination therapy group.Thirty-nine patients with medium and high risk MDS who were treated with Decitabine (25 mg/m2) alone were randomly selected during the same period of time as monotherapy group.The levels of serum ferritin,folic acid and vitamin B12 were observed before treatment and 2 weeks after the end of treatment.The clinical efficacy was evaluated.In addition,the 2-year overall survival,median survival time,toxicity and adverse reactions were compared between the two groups.Results Overall response rate and overall survival in combination group and monotherapy group was 85.19％ vs 79.49％ and 40.74％ vs 30.77％ respectively (P ＞ 0.05).The median survival time in combination group and monotherapy group was 19 and 15 months respectively,and the difference was statistically significant (P ＜ 0.05).After treatment,the levels of serum ferritin and vitamin B12 were significantly lower in combination group than in monotherapy group (P ＜ 0.05).Serum ferritin,folic acid and vitamin B12 levels were significantly decreased after treatment in both groups (P ＜0.05).The levels of myelosuppression,infection,nausea,vomiting and liver function impairment did not differ significantly in both groups (P ＞0.05).Conclusion Low-dose Capecitabine combined with Cytarabine in the treatment of patients with medium and high risk MDS has several advantages,including prolonging the survival time and reducing serum ferritin and vitamin B12 of patients.