[Clinical Efficacy of Low-dose Decitabine Combined with CAG Regimen in Patients with Myelodysplastic Syndrome-refractory Anemia with Excess Blasts(MDS-RAEB)]

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Oct;25(5):1482-1486. doi: 10.7534/j.issn.1009-2137.2017.05.035.
[Article in Chinese]

Abstract

Objective: To investigate the clinical efficacy of low-dose decitabine combined with CAG regimen in patients with myelodysplastic syndrome-refractory anemia with excess blasts (MDS-RAEB) through retrospective analysis.

Methods: Thirty-six patients with MDS-RAEB who ever received low-dose decitabine combined with CAG regimen were enrolled into decitabine + CAG group and 40 patients with MDS-RAEB treated by decitabine alone in our center were enolled into the control group. The clinical characteristics, efficacy and adverse reactions (AE) were compared between the 2 groups.

Results: Compared with the control group, the overall response rate (ORR) [complete remission (CR)+partial remission (PR) + hematologic improvement (HI) rate] of the decitabine+CAG group was higher (83.3% vs 62.5%)(P=0.043), and the AEs were not significantly increased. Cytopenia grade ≥3 and infection after treatment were the most prevalent AEs, which occurred in the early stage (within the first 2 cycles) and gradually decreased later. Other non-hematologic AEs were infrequent.

Conclusion: Low-dose decitabine combined with CAG regimen has better clinical efficacy for patients with MDS-RAEB than that of decitabine alone. It is worthy to be applied in clinic, especially for these patients who are not ineligible for hematopoietic stem cell transplantation.

MeSH terms

  • Aclarubicin / administration & dosage
  • Anemia, Refractory, with Excess of Blasts / drug therapy*
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Azacitidine / analogs & derivatives*
  • Azacitidine / therapeutic use
  • Cytarabine / administration & dosage
  • Decitabine
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Humans
  • Myelodysplastic Syndromes / drug therapy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Aclarubicin
  • Decitabine
  • Azacitidine

Supplementary concepts

  • CAG protocol