Decitabine for myelodysplastic syndromes: dose comparison in a real world clinical setting

Abstract

Abstract We retrospectively studied 133 myelodysplastic syndrome patients receiving decitabine during January 2009 and September 2017. The dose of 15\u2009mg/m2/d (n\u2009=\u200983) and 20\u2009mg/m2/d (n\u2009=\u200950) had comparable overall response rates (ORR) (51.8% vs. 52.00%) and complete remission rate (CRR) (15.66% vs. 22.00%). The 15\u2009mg/m2/d group had a lower incidence of grade 3/4 neutropenia (60.24% vs. 88.00%, p\u2009<\u2009.05) and thrombocytopenia (65.06% vs. 88.00%, p\u2009<\u2009.05). The 15\u2009mg/m2/d group had a longer median overall survival (OS) (21.60 months vs. 15.23 months, p\u2009=\u2009.02). The same results were seen in refractory anemia with excess blasts (RAEB) patients: The 15\u2009mg/m2/d group also had comparable ORR, CRR, decreased hematological toxicities and longer OS. Further analysis suggested that survival benefit of 15\u2009mg/m2/d group was mainly in those patients with lower risk stratification. In conclusion, 15\u2009mg/m2/d decitabine is associated with a lower incidence of hematological toxicities and longer OS and may be more suitable for patients with relatively lower risk.