在低风险的MDS中,低剂量的Decitabine与低剂量的azacitidine对比较低
Koji Sasaki1, Elias Jabbour1, Guillermo Montalban-Bravo1
1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston.
NEJM evidence
|February 6, 2024
概括
较低风险的骨髓发育综合征 (MDS) 用减弱剂量的低甲基化剂治疗,如德西他和阿扎丁,改善了结果,包括输血独立性,没有显著的副作用.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 低甲基化剂是骨髓质疏松综合征 (MDS) 的标准药物.
- 它们在较低风险的MDS中的有效性仍然不清楚.
- 国际预测评分系统 (IPSS) 的风险分层是至关重要的.
研究的目的:
- 评价先前未经治疗的低风险MDS患者的decitabine与azacitidine.
- 评估治疗结果,包括反应率和输血独立性.
主要方法:
- 贝叶斯响应适应性随机试验.
- 113名患有低/中等-1风险MDS的患者.
- 德西塔 (20毫克/米2) 与阿扎西蒂丁 (75毫克/米2) 每天每28天进行3天.
主要成果:
- 总体响应率:67% (德西塔) 与48% (阿扎西提丁) 相比.
- 在依赖输血的患者中,41% (德丁) 与15% (阿扎西提丁) 实现了输血独立.
- 平均整体生存时间:33个月;无事件生存时间:17个月.
结论:
- 减弱剂量的低甲基化剂改善了较低风险的MDS的结果.
- 治疗有效的患者被定义为高风险的低风险预后评分系统.
- 在这个队列中没有观察到剂量限制的副作用.
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