Role of Decitabine in Myelodysplastic Syndrome-An Experience from a Tertiary Care Centre

A number of emerging therapeutic options are currently being evaluated for the treatment of MDS that will, add to the treatment options for patients who are ineligible to receive HSCT or intensive chemotherapy. Decitabine has recently been approved by FDA for the treatment of MDS. The aim of our study was to evaluate efficacy of Gemcitabine verses best supportive treatment in myelodysplastic syndrome. 48 subjects with myelodysplasia who attended clinical hematology OPD or were admitted in the concerned ward were enrolled as from June, 2014 to May, 2016. The diagnosis was based on history, clinical examination, bone marrow examination and cytogenetics. 31 subjects were taken as controls among whom 12 (38.7%) were males and 19 (61.3%) were females with mean age of 62.81 ± 9.232 years. 17 subjects were taken as cases among whom 7 (41.2%) were males and 10 (58.8%) were females with mean age of 53.82 ± 13.626 years. In our study, there was no statistically significant difference in hematologic improvement and overall survival among subjects receiving best supportive care and Decitabine compared to the subjects receiving best supportive care only. However, among subjects who received Decitabine there was statistically significant rise in mean hemoglobin level from 5.7 gm% to 7.1 gm% and there was statistically significant reduction in RBC transfusion requirement from mean of 2.76 transfusions per month to 1.09 transfusions per month with P value of <0.05. Decitabine treatment was associated with only limited non-hematologic toxicity. Myelosuppression was the major adverse effect; particularly during early treatment (prolonged cytopenias in some patient’s necessitated delay of subsequent treatment or even termination).