title: [The efficacy and safety of valproic acid in combination with low dose chemotherapy on intermediate and high-risk myelodysplastic syndrome].
abstract: OBJECTIVE
  To evaluate the efficacy and adverse effect of valproic acid (VPA) in combination with low dose chemotherapy on intermediate and high-risk myelodysplastic syndrome.
  
  
  METHODS
  A total of 41 patients with intermediate (34) and high-risk (7) myelodysplastic syndrome were retrospectively analyzed. Among them, 19 patients received low dose chemotherapy regimen and 22 received low dose chemotherapy plus VPA. Low dose chemotherapy regimen included: homoharringtonine, 1 - 2 mg×m(-2)×d(-1) intravenously, 14 - 28 d; aclarubicin, 5 - 7 mg×m(-2)×d(-1) intravenously, 1 - 8 d, 15 - 23 d; cytarabine 15 mg/m(2) subcutaneously once every 12 h, 14 - 21 d; and subcutaneously use of granulocyte colony-stimulating factor 200 µg·m(-2)×d(-1) when neutrophil deficiency. The outcome and adverse effect were recorded after the treatment.
  
  
  RESULTS
  The overall response rate in the low dose chemotherapy regimen group was 47.4% (9/19), 6 patients (31.6%) achieved complete response (CR). The overall response rate in the VPA group was 77.2% (17/22), 9 patients (40.9%) achieved CR. The overall response rate of the low dose chemotherapy in combination with VPA group was significantly higher than that in the low dose chemotherapy group (P < 0.05) while no difference was found in CR rate. The adverse effect of the low dose chemotherapy in combination with VPA regimen was tolerated.
  
  
  CONCLUSIONS
  With acceptable adverse effect, the low dose chemotherapy in combination with VPA regimen is effective for the treatment of intermediate and high-risk myelodysplastic syndrome. Long-term outcome needs further investigation.
authors: Department of Hematology, the First Affiliated Hospital of Xinxiang Medical College, Weihui City Henan Prorence 453100, China.
authors: Qing-yi
authors: QY
authors: Zhang
authors: Gui-min
authors: GM
authors: Ge
authors: Yi-peng
authors: YP
authors: Yan
authors: Xiao-lin
authors: XL
authors: Han
authors: Yan
authors: Y
authors: Huang
authors: Sun
authors: S
authors: Wu
authors: Li-shan
authors: LS
authors: He