Prognostic factors associated with disease progression and overall survival in patients with myelodysplastic syndromes treated with decitabine.

Decitabine improves overall survival (OS) and reduces risk of progression to acute myeloid leukemia (AML) in myelodysplastic syndromes (MDS). In this retrospective analysis of data from 2 decitabine studies (n = 162), hemoglobin level ≥ 10 g/dL, platelet count ≥ 50 10(3)/μL, and lack of chromosome 5 or 7 abnormalities predicted longer OS. Identifying potential prognostic factors for survival may guide decitabine treatment decisions and improve outcomes.

Background: Myelodysplastic syndromes (MDS) progress to acute myeloid leukemia (AML) in approximately 30% of patients. Identification of risk factors for progression to AML and overall survival (OS) would help guide treatment decisions.

Methods: We investigated prognostic factors for progression to AML and survival in 163 patients with MDS treated with decitabine 15 mg/m(2) over 3 hours every 8 hours for 3 days every 6 weeks (n = 74) or 20 mg/m(2) over 1 hour daily for 5 days every 4 weeks (n = 89).

Results: Multivariate analysis of pooled baseline data revealed that only study effect was associated with progression to AML. A hemoglobin value at least 10 g/dL, platelet count at least 50 × 10(3)/μL, and lack of chromosome 5 or 7 abnormalities were associated with longer OS.

Conclusions: Patients with certain prognostic factors should be considered for other interventions in addition to decitabine treatment.