Outcome of patients with myelodysplastic syndrome after failure of decitabine therapy

Abstract

Background: The prognosis of patients with myelodysplastic syndrome (MDS) after decitabine failure is not known.

Methods: Data from 87 patients with MDS (n=67) and chronic myelomonocytic leukemia (n=.20) after failure of decitabine regimens were reviewed.

Results: After a median follow-up of 21 months from decitabine failure, 13 (15%) patients remained alive; the median survival was 4.3 months, and the estimated 12-month survival rate was 28%. The estimated 12-month survival rates were 27%, 33%, and 33%, respectively, for patients with high-risk, intermediate-2-risk, and intermediate-1-risk disease (P=.99) by the International Prognostic Scoring System. The estimated 12-month survival rates were 100%, 54%, 41%, and 18%, respectively, for patients with low-risk, intermediate-1-risk, intermediate-2-risk, and high-risk disease according to The University of Texas M. D. Anderson Cancer Center risk model (P=.01).

Conclusions: The outcome of patients after decitabine failure is poor and appears to be predictable after decitabine failure.

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES

The authors have received financial support from the Betty Foster Leukemia Research Fund. These funds were used to help defray the cost for research nurses.

Copyright (c) 2010 American Cancer Society.

Figures

Figure 1

Overall survival after decitabine failure is shown (A) overall, (B) by the International Prognostic Scoring System (IPSS), and (C) by The University of Texas M. D. Anderson Cancer Center risk model. MDS indicates myelodysplastic syndrome; AML, acute myeloid leukemia.

Figure 2

Outcome after decitabine failure is shown (n = .87). AML indicates acute myeloid leukemia; MDS, myelodysplastic syndrome; ET, experimental therapies; NT, no therapy; IA, idarubicin and cytarabine; ASCT, allogeneic stem cell transplantation; UT, unknown therapy; CR, complete remission; mCR, (bone) marrow complete remission; HI, hematologic improvement.