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Clinical Outcomes of Decitabine Treatment for Patients With Lower-Risk Myelodysplastic Syndrome on the Basis of the International Prognostic Scoring System
- Clinical Outcomes of Decitabine Treatment for Patients With Lower-Risk Myelodysplastic Syndrome on the Basis of the International Prognostic Scoring System
- Jung, Ki Sun; Kim, Yoo-Jin; Kim, Yeo-Kyeoung; Park, Sung Kyu; Kim, Hoon Gu; Kim, Soo Jeong; Park, Jinny; Choi, Chul Won; Do, Young Rok; Kim, Inho; Park, Seonyang; Mun, Yeung-Chul; Jeong, Seong Hyun; Kim, Min-Kyoung; Yi, Hyeon Gyu; Chang, Myung Hee; Kim, Su Youn; Lee, Je-Hwan; Jang, Jun Ho
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- CLINICAL LYMPHOMA MYELOMA & LEUKEMIA
- CLINICAL LYMPHOMA MYELOMA & LEUKEMIA vol. 19, no. 10, pp. 656 - 664
- Decitabine; IPSS; Lower-Risk Prognostic Scoring System; LR-PSS; Myelodysplastic syndrome
- CIG MEDIA GROUP, LP
- Document Type
- Decitabine showed a survival benefit in the higher-risk group (Lower-Risk Prognostic Scoring System [LR-PSS] category 3) of the International Prognostic Scoring System (IPSS) lower-risk (IPSS low or intermediate-1) myelodysplastic syndrome patients who responded to decitabine. Therefore, classification using the LR-PSS category was helpful for this subgroup, indicating that decitabine treatment might alter the natural course of disease in these patients. Introduction: Decitabine has shown clinical benefits in patients with intermediate (INT)-2 or high-risk myelodysplastic syndrome (MDS), determined according to the International Prognostic Scoring System (IPSS), but the benefits have not been well demonstrated in patients with lower-risk (IPSS low or INT-1) disease. Recently, it was proposed that the prognosis for patients with IPSS lower-risk disease is heterogeneous, with a substantial proportion of these patients having poor survival. Patients and Methods: This study included patients with IPSS lower-risk MDS from the DRAMA (An Observational Study for Dacogen Long-Term Treatment in Patients With Myelodysplastic Syndrome; NCT01400633) and DIVA (A Study for Dacogen Treatment in Patients With Myelodysplastic Syndrome; NCT01041846) studies, which were prospective observational studies on the efficacy and safety of decitabine treatment in patients with MDS. Using the Lower-Risk Prognostic Scoring System [LR-PSS], we classified IPSS lower-risk MDS. Patients in each LR-PSS category were divided according to overall response (OR) to decitabine treatment, and survival outcomes were compared. Results: One hundred sixteen patients were enrolled: LR-PSS category 1 (n = 12; 10.3%), category 2 (n = 56; 48.3%), and category 3 (n = 48; 41.4%). Survival outcomes differed among the 3 categories (P = .046). The overall survival according to OR showed a significant difference in total patients (P = .008) and category 3 patients (P = .003). We analyzed predictive factors for OR, but no variable was found to significantly affect OR. Conclusion: Decitabine treatment showed a survival benefit in the higher-risk group of IPSS lower-risk MDS patients who responded to treatment, and classification using the LR-PSS category was helpful for this subgroup, indicating that decitabine treatment might alter the natural course of disease in these patients.
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