Very-low-dose decitabine treatment for patients with intermediate- or high-risk myelodysplastic syndrome: a retrospective analysis of thirteen cases

Ann Hematol. 2020 Nov;99(11):2539-2546. doi: 10.1007/s00277-020-04268-z. Epub 2020 Sep 17.

Abstract

Decitabine is a hypomethylating drug that is used to treat myelodysplastic syndrome (MDS) at a recommended dose and schedule (20 mg/m2 per day, for 5 consecutive days). However, due to its relatively high incidence of side effects and its effects on neoplastic cells, many studies have begun to explore the clinical application of a low dose of decitabine for treating MDS. In this retrospective study, we examined the effects of a very-low-dose decitabine schedule for treating MDS. A total of 13 patients diagnosed with de novo MDS received a schedule of intravenous decitabine administration at 6 mg/m2 per day for 7 days, repeated every 4 weeks. The complete response rate was 30.8%, and the overall response rate was 69.2%. In patients with complete remission, the median time to granulocyte recovery greater than 0.5 × 109/L during complete remission (CR) was 15 days. In patients with remission, the median time to granulocyte recovery greater than 0.5 × 109/L was 10.5 days. The 1-year survival rate was 72.7% and the median survival was 28.0 months. In summary, we demonstrated that a very-low-dose decitabine schedule has an appreciable response and survival rate, as well as appreciable tolerance and medical compliance for treating MDS.

Keywords: Decitabine; Hypomethylating drugs; Myelodysplastic syndrome; Very low dose.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Decitabine / administration & dosage*
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes* / blood
  • Myelodysplastic Syndromes* / drug therapy
  • Myelodysplastic Syndromes* / mortality
  • Remission Induction
  • Retrospective Studies
  • Risk Factors
  • Survival Rate

Substances

  • Decitabine