title: [Clinical Efficacy Comparison of Ultralow Dose of Decitabine and Cyclosporine on Low-risk and Intermediate-risk Type 1 of Myelodysplastic Syndrome].
abstract: OBJECTIVE
  To evaluate the clinical efficacy and safety of decitabine and cyclosporine for treatment of low-risk and intermediate-risk-1 myelodysplastic syndrome (MDS) patients.
  
  
  METHODS
  The clinical data of 27 cases of low risk and intermediate-risk-1 MDS during the past 3 years in Tongji hospital were analyzed retrospectively. These MDS patients were divided into 2 groups: decitabine group (11 cases) and cyclosporine group (16 cases). The MDS patients in the 2 groups were treated with ultra low dose of decitabine and cyclosporine A; the curetive efficacy and adverse reactions were evaluated.
  
  
  RESULTS
  In the 11 patients with low-risk and intermediate-risk-1 MDS treated with 2 courses of ultra-low-dose decitabine, 4 cases (36.4%) achieved a hematological improvement, 7 cases (63.6%) showed ineffective, including non-remission in 6 cases (54.5 %) and death in 1 patient (9.1%), total effective rate were 36.4%; 3 cases died within the first year and the overall survival (OS) rate was 72.7%. The causes of death mainly were severe myelosuppression and the associated infection and bleeding. In the 16 patients with low-risk and intermediate-risk-1 MDS treated with cyclosporine (CsA), 10 cases (62.5%) achieved a hematological improvement, 6 cases (37.5%) showed ineffective, the total efficiency of 62.5%; no patients died within 1 year, the 1-year OS was 100%. Changes in neutrophils, hemoglobin and platelet were not significantly different between the two group.
  
  
  CONCLUSIONS
  The clinical efficacy of decitabine on low-risk and intermediate-risk-1 MDS has not confirmed to be superior to cyclosporine (P = 0.252). However, the side effects of serious infection and myelosuppression were more severe in decitabine group than that in the cyclosporine group. Moreover, the 1-year overall survival rate in decitabine group is much lower than that in the cyclosporine group (P = 0.027). In regard to the small number of cases and short follow-up time in our this study, the more patients and longer follow-up time are needed to study.
authors.affiliation: Department of Hematology, Tongji Hospital of Tongji University, Shanghai 200065, China.
authors.forename: Xiu
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Hematology, Tongji Hospital of Tongji University, Shanghai 200065, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Hematology, Tongji Hospital of Tongji University, Shanghai 200065, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of Hematology, Tongji Hospital of Tongji University, Shanghai 200065, China.
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Department of Hematology, Tongji Hospital of Tongji University, Shanghai 200065, China. E-mail: lab7182@tongji.edu.cn.
authors.forename: Ai-Bin
authors.initials: AB
authors.lastname: Liang
mesh_terms: D001374:Azacitidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D000077209:Decitabine; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D010198:Pancytopenia; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000077209:Decitabine; D016572:Cyclosporine; D001374:Azacitidine