title: Comparison of 7-day azacitidine and 5-day decitabine for treating myelodysplastic syndrome.
abstract: Two DNA methyltransferase inhibitors, azacitidine and decitabine, are currently approved for the treatment of myelodysplastic syndrome (MDS). Choosing between these drugs is an important practical issue. In this retrospective study, patients receiving AZA-7d (azacitidine 75 mg/m2 subcutaneously × 7 days, n = 75) or DEC-5d (decitabine 20 mg/m2 intravenously × 5 days, n = 74) were compared. The rates of hematologic response (complete response [CR]/partial response [PR]/marrow CR) were 12.0 % (AZA-7d) vs. 29.7 % (DEC-5d) (P = 0.008), and the overall response rates (CR/PR/marrow CR/hematologic improvement) were 52.0 % (AZA-7d) vs. 63.5 % (DEC-5d) (P = 0.155). Grade 3 or higher neutropenia occurred more frequently with DEC-5d (79.6 %) than with AZA-7d (72.2 %) (P = 0.040). Overall survival probabilities at 2 years were 42.1 % (AZA-7d) vs. 42.2 % (DEC-5d) (P = 0.944). Subgroup analysis revealed that AZA-7d associated with higher survival rates than DEC-5d in patients whose MDS duration exceeded 1 year or who had poor performance status. In conclusion, both AZA-7d and DEC-5d regimens were effective in treating patients with MDS. However, the two regimens differed in terms of clinical responses and toxicities. One hypomethylating regimen may be superior to the other regimen in particular subgroups.
authors: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, South Korea. jhlee3@amc.seoul.kr
authors: Je-Hwan
authors: JH
authors: Lee
authors: Yunsuk
authors: Y
authors: Choi
authors: Sung-Doo
authors: SD
authors: Kim
authors: Dae-Young
authors: DY
authors: Kim
authors: Jung-Hee
authors: JH
authors: Lee
authors: Kyoo-Hyung
authors: KH
authors: Lee
authors: Sang-Min
authors: SM
authors: Lee
authors: Su-Hee
authors: SH
authors: Cho
authors: Won-Sik
authors: WS
authors: Lee
authors: Young-Don
authors: YD
authors: Joo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001374:Azacitidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D000076123:DNA (Cytosine-5-)-Methyltransferase 1; D004248:DNA (Cytosine-5-)-Methyltransferases / Q000037:antagonists & inhibitors; D019175:DNA Methylation / Q000187:drug effects; D000077209:Decitabine; D004341:Drug Evaluation; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004791:Enzyme Inhibitors; D000077209:Decitabine; D000076123:DNA (Cytosine-5-)-Methyltransferase 1; D004248:DNA (Cytosine-5-)-Methyltransferases; D001374:Azacitidine