BƯỚC ĐẦU ĐÁNH GIÁ HIỆU QUẢ ĐIỀU TRỊ CỦA DECITABINE TRÊN NGƯỜI BỆNH LOẠN SINH TỦY TẠI BỆNH VIỆN TRUYỀN MÁU HUYẾT HỌC

Abstract

Aims: To evaluate the therapeutic efficacy and toxicity of decitabine in MDS (Myelodysplastic syndromes) patients. Subjects and methods: Descriptive case series. Patients who were diagnosed with MDS, suitable with the inclusion criteria and received treatment with decitabine 20mg/m²/ day x 5 days from January 2019 to July 2021 were included and analyzed retrospectively. Treatment response evaluation is set according to IWG 2006. Results: Thirty-two patients were selected (18 males, 14 females) in whom the highest proportion was MDS-EB2 (56.2%) according to WHO 2016 classification. The vast majority according to IPSS-R was the very high-risk group with 56.2%. Patients were treated from 1 to 11 cycles of decitabine with an overall response rate (ORR) of 21.9%; of which complete response (CR) 12.5% and partial response (PR) 9.4%. Complete bone marrow response (mCR) was 25%. The group of patients treated for > 4 cycles achieved a higher ORR, CR, time overall survival (OS), progression-free survival (PFS), acute myeloid leukemia-free survival (AMLFS) more than those treated with ≤ 4 cycles (p respectively: p = 0.032; 0.009; 0.007; 0.01; 0.009). The proportion of patients who became independent of red blood cell and platelet transfusion increased by cycles over time, with same as 40% at sixth cycle. Median follow-up was 7 months with median OS; PFS; AMLFS: 12.3; 7.9; 11.6 months, respectively (95% CI). OS and AMLFS lasted longer in patients who achieved PR/CR (p respectively: 0.004; 0.016). Common grade 3; 4 - complications during treatment were: infection 68.7%; neutropenia 68.7%; thrombocytopenia 65.6%; anemia 56.2%. Treatment complication death 18.7% of patients (mainly due to infection/ severe neutropenia). Conclusion: Decitabine is effective in improving hematopoiesis, reduction of blood transfusion needs and prolonging OS, PFS, AMLFS in MDS patients, especially those who get response.