Hipometile edici ajan tedavisi alan klonal myelod neoplazili hastaların verilerinin retrospektif analizi

Abstract

Introductıon and Purpose: Myelodysplastic syndrom (MDS) is a clonal stem-cell disorder characterized by ineffective hematopoiiesis associated with cytopenias and a high risk for progression to acute leukemia (AML). Hypomethylating agents (HMA) - Azacitidine or Decitabine are recently used in MDS patients – especially high risk patients – who have been treated with supportive therapy, conventional chemotherapy and allogenic bone marrow transplantation (BMT) whenever possible. Main goal of this study is to show the efficiency of hypomethylating agents and epigenetic treatments in MDS patients regarding disease control. Material and Methods: Medical records of 58 MDS patients and 14 AML patients were analyzed retrospectively. Kaplan Meiere method was used in survival analysis. Comparison of survival curves were done using long-rank test. Chi-square test was used to evaluate categorical variables. “Student’s test” and “Mann Whitney U” tests were used to study the numeric variables with respect to independent categorical variables. P value limit of significance was taken as 0,05 in statistical comparisons. Findings: Among the patients taken into study , (overall survivall) OS was 24,6 months and 12-months overall survival was found to be %70,7. There was no significant difference between Azacitidine and Decitabine regarding OS (25,1 months and 23,1 months p=0,228). Grade 3-4 cytopenias were the most common complications that developed after treatment. OS was found to be shorter in patients who experienced grade 3-4 trombocytopenia and anemia (p=0,011 and p=0,049 respectively). Response to treatment was found to be %48,3 in patients who received Azacitidine and %41,7 in patients who received Decitabine (p=0,758). Results: İn retrospectife analise of our study population hypomethylating agent treatments in AML and MDS patients provide high survival. Azacitidine and Decitabine treatment can be used instead of chemotherapy in this group of patients. There is no significant difference between Dacitabine and azacitidine treatments regarding general survival.