Treatment of Vietnamese patients diagnosed with myelodysplastic neoplasms: Practical experience in a developing country

Abstract

Background: Treatment of patients diagnosed with myelodysplastic neoplasms (MDS) is difficult and the outcome is still limited, especially in developing countries. We conducted this study in order to share some experience in treating patients diagnosed with MDS in developing countries.

Methods: This was a retrospective study that included 32 patients with newly MDS. 13 lower-risk patients, including 2 patients with MDS 5q- were treated with erythropoiesis stimulating agent (ESA). 19 patients with higher risk were treated with hypomethylating agent (HMA), which was decitabine.

Results: In the ESA treatment group, the rate of hematologic improvement-erythroid was 69.2 %, the rate of total hematologic improvement (with 3 lineages improvement) was 61.5 %. In the HMA treatment group, the overall response rate was 52.6 %. The follow-up times were 42 months. The overall survival (OS), leukemic transformation-free survival (LFS), and progression-free survival (PFS) of the ESA treatment group were 30.44, 28.91, and 28.29 months; respectively. The OS, LFS, and PFS of the HMA treatment group were 34.27, 31.45, and 26.83 months; respectively.

Conclusions: Patients with lower risk MDS, including MDS 5q-, may benefit from treatment with erythropoiesis stimulating agent (ESA). Patients with higher risk MDS may have a favorable outcome with decitabine (HMA) treatment.

Keywords: Decitabine; Erythropoiesis stimulating agent; Hypomethylating agent; MDS; Myelodysplastic neoplasms.

Fig. 1

Overall survival (OS) according to treatment regimen: ESA (erythropoiesis stimulating agent), HMA (hypomethylating agent).

Fig. 2

Leukemic transformation- free survival (LFS) according to treatment regimen: ESA (erythropoiesis stimulating agent), HMA (hypomethylating agent).

Fig. 3

Progression- free survival (PFS) according to treatment regimen: ESA (erythropoiesis stimulating agent), HMA (hypomethylating agent).