Abstract：【Objective】To investigate the association of decitabine efficacy with immune lymphocyte counts in elderly patients with myelodysplastic syndrome. 【Methods】The clinical data of 63 elderly patients with myelodysplastic syndrome treated in our hospital from March 2014 to May 2016 were retrospectively analyzed. According to the absolute value of lymphocyte counts on the 28th day after the first treatment of decitabine (DAC), patients were divided into the high lymphocyte group (H-Lym group, 27 cases, absolute lymphocyte count≥1.2×109/L) and the low lymphocyte group (L-Lym group, 36 cases, absolute lymphocyte count<1.2×109/L). The differences in baseline data, total response rate (ORR), and progression-free survival (PFS) between the two groups were compared, and the risk factors for differences in PFS between the two groups were analyzed. 【Results】 (1) There were no significant differences in gender, age, IPSS classification, complete blood count, karyotype and treatment-related death between the two groups (P>0.05). Compared to the L-Lym group, the proportion of patients with ≥10% of the original cells in the H-Lym group was significantly higher (P<0.05). (2) At the time of diagnosis, there was no significant difference in lymphocyte count between the two groups (P>0.05). After receiving the first course of DAC, the lymphocyte counts in the H-Lym group were not significantly different from those in the diagnosis (P>0.05). However, the lymphocyte counts in the L-Lym group after the first course of DAC treatment were significantly lower than those in the diagnosis (P<0.05). (3) The ORR of the H-Lym group was 81.48%, which was significantly higher than that of the L-Lym group (38.89%) (P<0.05). Patients in the relatively high-risk group were more likely to respond to DAC therapy than patients with a relatively low-risk group of IPSS (P<0.05). (4) The median PFS value of patients in the H-Lym group was 10.7 months (95% CI, 7.9~13.5 months), which was significantly higher than that of the L-Lym group 8.1 months (4.3 to 11.9 months) (P<0.05). Correlation analysis showed that high lymphocyte count was a risk factor for difference in PFS between the two groups. 【Conclusion】Patients with absolute lymphocyte count≥1.2×109/L on the 28th day after the first treatment of DAC have higher total response rate (ORR) and progression-free survival (PFS), which can be used for early prediction of DAC response.
刘玉, 陈凯, 陈润. 地西他滨治疗老年骨髓增生异常综合征患者临床疗效及与免疫淋巴细胞计数的关系[J]. 医学临床研究, 2019, 36(7): 1293-1296.
LIU Yu, CHEN Kai, CHEN Run. Association of Clinical Efficacy of Decitabine with Immune Lymphocyte Counts in Elderly Patients with Myelodysplastic Syndrome. JOURNAL OF CLINICAL RESEARCH, 2019, 36(7): 1293-1296.
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2019, Vol. 36 
