The effect of decitabine dose modification and myelosuppression on response and survival in patients with myelodysplastic syndromes

Abstract

Myelosuppression in myelodysplastic syndromes (MDS) is associated with the hypomethylating agent decitabine. A retrospective pooled analysis of two decitabine clinical trials in patients with MDS conducted Cox regression analyses of red blood cell or platelet dependence, myelosuppression, dose modification, cycle delay or dose reduction, and survival effects. In 182 patients, baseline platelet dependence was a predictor for dose modification, reduction or delay, and death (modification: p = 0.006, hazard ratio [HR] = 2.04; reduction/delay: p = 0.011, HR = 2.00; death: p = 0.003, HR = 1.94). Patients with dose modifications had significantly higher overall response rates versus those with none (22% vs. 10%; p = 0.015). Patients with no dose modifications had faster progression to acute myeloid leukemia (AML) versus patients with dose modifications (p = 0.004). Without dose modifications, patients tended to drop out due to disease progression or other reasons. Decitabine dose modifications on treatment may indicate response to treatment.

Keywords::

• Dacogen
• decitabine
• myelodysplastic syndromes
• retrospective study

Acknowledgements

This study was supported by research funding from Eisai Inc. Yvonne E. Yarker, PhD, CMPP, of Peloton Advantage, a medical writer supported by funding from Eisai Inc., provided medical writing and editorial assistance to the authors during the preparation of this manuscript.

Potential conflict of interest:

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