A 2-Year Single Center Experience of Decitabine Treatment for the Patients with MDS and CMML

Decitabine is effective to MDS and CMML patients. However few long term follow up data has been reported. We report a 2 year, single-institutional data of decitabine treatment in patients with MDS and CMML.

Patients and Methods: Patients were treated with decitabine 20 mg/m2 by IV infusion daily for 5 consecutive days every 4 weeks. Bone marrow examination was performed every 2 cycles. The response was evaluated according to IWG 2006 criteria.

Results: Fifty-four patients were evaluated. The median age was 63.5 years (range, 23–80) and the median cycle was four. (range 2–15). Among 54 patients, 13 were complete responses(CR), 1 partial response, 10 marrow CRs(mCR), 6 hematologic improvements, respectively. The overall response rate was 44.3% and overall improvement rate was 55.6% which included six patients with hematologic improvement. Among responders, 28 (93.4%) patients showed response at least in two cycles. Out of 18 patients with intermediate or poor cytogenetic abnormalities, only one patient had demonstrated cytogenetic CR. Out of total 326 cycles, 24 events of febrile neutropenia, nine events of bacterial pneumonia, eight events of fungal pneumonia, four events of bleeding and two events of hepatic dysfunction were occurred, and most complications were medically manageable. 10 out of 13 CR patients were maintained CR with decitabine treatment. The median overall survival duration was 20.2 months (95% CI 14.6 – 25.8). Stopping decitabine treatment had led to leukemic progression within 3 to 5 months in four patients who had achieved mCR and three patients who had achieved CR.

Conclusion: Five day scheduled decitabine treatment demonstrated rapid and durable response in patients with MDS. However, even after achieving clinical response, keeping decitabine treatment seems to be necessary to prevent leukemic progression. Further study for role of maintenance therapy is needed.

No relevant conflicts of interest to declare.