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. 2015 Jun 30;6(18):16653-62.
doi: 10.18632/oncotarget.3914.

Platelet response during the second cycle of decitabine treatment predicts response and survival for myelodysplastic syndrome patients

Hyun Ae Jung  1   2 , Chi Hoon Maeng  3 , Moonjin Kim  1 , Sungmin Kim  1 , Chul Won Jung  1 , Jun Ho Jang  1
Affiliations

Platelet response during the second cycle of decitabine treatment predicts response and survival for myelodysplastic syndrome patients

Hyun Ae Jung et al. Oncotarget. .

Abstract

Despite the efficacy of decitabine to myelodysplastic syndrome (MDS), there is a wide range of responses, and no definite predictive marker has been identified. This study aimed to describe the efficacy of decitabine and to identify potential predictors of response and survival in patients with MDS. We retrospectively analyzed clinical data of MDS patients at Samsung Medical Center between August 2008 and August 2011. The response assessment was conducted using the International Working Group (IWG) response criteria for MDS. We analyzed 101 MDS patients (total 613 cycles) who received decitabine for a median of four cycles. The overall response was 52.5% (n = 53/101). The median time to any response was two cycles with the median overall survival of 16.7 months. Patients who showed hematologic improvement had significantly longer survival than those who did not (9.8 vs. 22.9 months, p = 0.004). The difference in OS was evident in the Intermediate-2/High risk group (p = 0.002) but not in the Intermediate-1 risk group (p = 0.145). Multivariate analysis confirmed that platelet response (no platelet transfusions for at least 3 days) during the second cycle of treatment was an independent predictor for response, OS and Leukemia free survival. Based on the results of this study, for patients with hematological improvement, recovery of platelet count by the second cycle of therapy can be used as an early predictive marker of improved survival and an increased response rate.

Keywords: myelodysplastic syndrome; platelet.

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Conflict of interest statement

CONFLICTS OF INTEREST STATEMENT

The authors do not have any financial disclosures or personal relationships with other people or organizations that could inappropriately influence this work.

Figures

Figure 1
Figure 1. Hematologic improvement and OS
A. HI-N after first cycle. B. HI-N after second cycle C. HI-E after first cycle D. HI-E after second cycle E. HI-P after first cycle F. HI-P after second cycle.
Figure 2
Figure 2. m-CR and OS in patients with BM blasts >5%
Figure 3
Figure 3. Survival curve based on the presence of hematologic improvement during treatment
A. Any HI in all patients during decitabine treatment (p-value = 0.040). B. Any HI in Low risk (IPSS INT-1/Low) patients during decitabine treatment (p-value = 0.145). C. Any HI in High risk (IPSS INT-2/High) patients during decitabine treatment (p-value =0.002).
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