Clinical outcomes of decitabine treatment for myelodysplastic syndrome patinents at the national insitute of hematology and blood transfusion
Main Article Content
Abstract
This study was conducted to evaluation of clinical outcomes of decitabine treatment for MDS patients. 43 MDS patients (according to WHO 2016) have been diagnosed and treated at the National Institute of Hematology and Blood Transfusion, Hanoi, Vietnam. Patients were grouped based on their risk level according to IPSSR standard and were singly treated with decitabine. Results showed that 43 patients treated with decitabine achieved a significantly high overall response rate of 60.5%, including 41.9% achieving complete responses and 18.6% partial responses. Median time progression to acute myelogenous leukemia stage was 21.8 months. The most common adverse effects included myelosuppression (neutropenia 27.9%, anemia 18.6% and thrombocytopenia 41.9%), constipation 32.6%, vomiting 27.9%, cough 23.3%, fever 18.6%, diarrhea 16.3%, and pneumonia 16.3%. Decitabine was found to be clinically effective in the treatment of patients in both lower - risk group and higher - risk group MDS, with proven durable responses.
Article Details
Keywords
RLST, MDS, Decitabine.
References
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10. Jung KS, Kim Y - J, Kim Y - K, et al. Clinical Outcomes of Decitabine Treatment for Patients With Lower - Risk Myelodysplastic Syndrome on the Basis of the International Prognostic Scoring System. Clin Lymphoma Myeloma Leuk. 2019;19 (10):656 - 664. doi:10.1016/j.clml.2019.06.003
11. Rollison DE, Howlader N, Smith MT, et al. Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001 - 2004, using data from the NAACCR and SEER programs. Blood. 2008;112 (1):45 - 52. doi:10.1182/blood - 2008 - 01 - 134858
12. What Are Myelodysplastic Syndromes? | American Cancer Society. Accessed August 11, 2020. https://www.cancer.org/cancer/myelodysplastic - syndrome/about/what - is - mds.html
13. Hong M, He G. The 2016 Revision to the World Health Organization Classification of Myelodysplastic Syndromes. J Transl Intern Med. 2017;5 (3):139 - 143. doi:10.1515/jtim - 2017 - 0002
14. Greenberg P, Cox C, LeBeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89 (6):2079 - 2088.
15. Greenberg PL, Tuechler H, Schanz J, et al. Revised International Prognostic Scoring System for Myelodysplastic Syndromes. Blood. 2012;120 (12):2454 - 2465. doi:10.1182/blood - 2012 - 03 - 420489
16. Montalban - Bravo G, Garcia - Manero G. Myelodysplastic syndromes: 2018 update on diagnosis, risk - stratification and management. Am J Hematol. 2018;93 (1):129 - 147. doi:10.1002/ajh.24930
17. Steensma DP. Myelodysplastic syndromes current treatment algorithm 2018. Blood Cancer J. 2018;8 (5):47. doi:10.1038/s41408 - 018 - 0085 - 4
18. Greenberg PL, Stone RM, Al - Kali A, et al. Myelodysplastic Syndromes, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw JNCCN. 2017;15 (1):60 - 87. doi:10.6004/jnccn.2017.0007
19. Lee B - H, Kang K - W, Jeon MJ, et al. Comparison between 5 - day decitabine and 7 - day azacitidine for lower - risk myelodysplastic syndromes with poor prognostic features: a retrospective multicentre cohort study. Sci Rep. 2020;10 (1):39. doi:10.1038/s41598 - 019 - 56642 - 1
20. Jabbour E, Short NJ, Montalban - Bravo G, et al. Randomized phase 2 study of low - dose decitabine vs low - dose azacitidine in lower - risk MDS and MDS/MPN. Blood. 2017;130 (13):1514 - 1522. doi:10.1182/blood - 2017 - 06 - 788497
21. Harel S, Cherait A, Berthon C, et al. Outcome of patients with high risk Myelodysplastic Syndrome (MDS) and advanced Chronic Myelomonocytic Leukemia (CMML) treated with decitabine after azacitidine failure. Leuk Res. 2015;39 (5):501 - 504. doi:10.1016/j.leukres.2015.02.004
22. Kantarjian H, Issa J - PJ, Rosenfeld CS, et al. Decitabine improves patient outcomes in myelodysplastic syndromes: Results of a phase III randomized study. Cancer. 2006;106 (8):1794 - 1803. doi:10.1002/cncr.21792
2. Montalban - Bravo G, Garcia - Manero G. Myelodysplastic syndromes: 2018 update on diagnosis, risk - stratification and management. Am J Hematol. 2018;93 (1):129 - 147. doi:10.1002/ajh.24930
3. Cazzola M, Malcovati L. Myelodysplastic Syndromes — Coping with Ineffective Hematopoiesis. http://dx.doi.org/10.1056/NEJMp048266. doi:10.1056/NEJMp048266
4. Myelodysplastic syndromes current treatment algorithm 2018 | Blood Cancer Journal. Accessed December 31, 2020. https://www.nature.com/articles/s41408 - 018 - 0085 - 4
5. Kantarjian H, Issa J - PJ, Rosenfeld CS, et al. Decitabine improves patient outcomes in myelodysplastic syndromes: results of a phase III randomized study. Cancer. 2006;106 (8):1794 - 1803. doi:10.1002/cncr.21792
6. Hong M, He G. The 2016 Revision to the World Health Organization Classification of Myelodysplastic Syndromes. J Transl Intern Med. 2017;5 (3):139 - 143. doi:10.1515/jtim - 2017 - 0002
7. Greenberg PL, Tuechler H, Schanz J, et al. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012;120 (12):2454 - 2465. doi:10.1182/blood - 2012 - 03 - 420489
8. Comparison between 5 - day decitabine and 7 - day azacitidine for lower - risk myelodysplastic syndromes with poor prognostic features: a retrospective multicentre cohort study | Scientific Reports. Accessed December 31, 2020. https://www.nature.com/articles/s41598 - 019 - 56642 - 1
9. Cheson BD, Greenberg PL, Bennett JM, et al. Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia. Blood. 2006;108 (2):419 - 425. doi:10.1182/blood - 2005 - 10 - 4149
10. Jung KS, Kim Y - J, Kim Y - K, et al. Clinical Outcomes of Decitabine Treatment for Patients With Lower - Risk Myelodysplastic Syndrome on the Basis of the International Prognostic Scoring System. Clin Lymphoma Myeloma Leuk. 2019;19 (10):656 - 664. doi:10.1016/j.clml.2019.06.003
11. Rollison DE, Howlader N, Smith MT, et al. Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001 - 2004, using data from the NAACCR and SEER programs. Blood. 2008;112 (1):45 - 52. doi:10.1182/blood - 2008 - 01 - 134858
12. What Are Myelodysplastic Syndromes? | American Cancer Society. Accessed August 11, 2020. https://www.cancer.org/cancer/myelodysplastic - syndrome/about/what - is - mds.html
13. Hong M, He G. The 2016 Revision to the World Health Organization Classification of Myelodysplastic Syndromes. J Transl Intern Med. 2017;5 (3):139 - 143. doi:10.1515/jtim - 2017 - 0002
14. Greenberg P, Cox C, LeBeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89 (6):2079 - 2088.
15. Greenberg PL, Tuechler H, Schanz J, et al. Revised International Prognostic Scoring System for Myelodysplastic Syndromes. Blood. 2012;120 (12):2454 - 2465. doi:10.1182/blood - 2012 - 03 - 420489
16. Montalban - Bravo G, Garcia - Manero G. Myelodysplastic syndromes: 2018 update on diagnosis, risk - stratification and management. Am J Hematol. 2018;93 (1):129 - 147. doi:10.1002/ajh.24930
17. Steensma DP. Myelodysplastic syndromes current treatment algorithm 2018. Blood Cancer J. 2018;8 (5):47. doi:10.1038/s41408 - 018 - 0085 - 4
18. Greenberg PL, Stone RM, Al - Kali A, et al. Myelodysplastic Syndromes, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw JNCCN. 2017;15 (1):60 - 87. doi:10.6004/jnccn.2017.0007
19. Lee B - H, Kang K - W, Jeon MJ, et al. Comparison between 5 - day decitabine and 7 - day azacitidine for lower - risk myelodysplastic syndromes with poor prognostic features: a retrospective multicentre cohort study. Sci Rep. 2020;10 (1):39. doi:10.1038/s41598 - 019 - 56642 - 1
20. Jabbour E, Short NJ, Montalban - Bravo G, et al. Randomized phase 2 study of low - dose decitabine vs low - dose azacitidine in lower - risk MDS and MDS/MPN. Blood. 2017;130 (13):1514 - 1522. doi:10.1182/blood - 2017 - 06 - 788497
21. Harel S, Cherait A, Berthon C, et al. Outcome of patients with high risk Myelodysplastic Syndrome (MDS) and advanced Chronic Myelomonocytic Leukemia (CMML) treated with decitabine after azacitidine failure. Leuk Res. 2015;39 (5):501 - 504. doi:10.1016/j.leukres.2015.02.004
22. Kantarjian H, Issa J - PJ, Rosenfeld CS, et al. Decitabine improves patient outcomes in myelodysplastic syndromes: Results of a phase III randomized study. Cancer. 2006;106 (8):1794 - 1803. doi:10.1002/cncr.21792