Abstract
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.
| Original language | English |
|---|---|
| Journal | Clinical Lymphoma, Myeloma and Leukemia |
| DOIs | |
| Publication status | Published - 2019 Jan 1 |
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Keywords
- Decitabine
- IPSS
- Lower-Risk Prognostic Scoring System
- LR-PSS
- Myelodysplastic syndrome
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research
Cite this
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.
In: Clinical Lymphoma, Myeloma and Leukemia, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical Outcomes of Decitabine Treatment for Patients With Lower-Risk Myelodysplastic Syndrome on the Basis of the International Prognostic Scoring System
AU - Jung, Ki Sun
AU - Kim, Yoo Jin
AU - Kim, Yeo Kyeoung
AU - Park, Sung Kyu
AU - Kim, Hoon Gu
AU - Kim, Soo Jeong
AU - Park, Jinny
AU - Choi, Chul Won
AU - Do, Young Rok
AU - Kim, Inho
AU - Park, Seonyang
AU - Mun, Yeung Chul
AU - Jeong, Seong Hyun
AU - Kim, Min Kyoung
AU - Yi, Hyeon Gyu
AU - Chang, Myung Hee
AU - Kim, Su Youn
AU - Lee, Je Hwan
AU - Jang, Jun Ho
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Decitabine
KW - IPSS
KW - Lower-Risk Prognostic Scoring System
KW - LR-PSS
KW - Myelodysplastic syndrome
UR - http://www.scopus.com/inward/record.url?scp=85069820918&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069820918&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2019.06.003
DO - 10.1016/j.clml.2019.06.003
M3 - Article
AN - SCOPUS:85069820918
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
SN - 2152-2650
ER -