Abstract:
Objective To evaluate the clinical efficacy and safety of decitabine combined with chemotherapy in the treatment of intermediate-and high-risk chronic myelomonocytic leukemia (CMML).
Methods Clinical data of 21 patients with intermediate-and high-risk CMML who received decitabine combined chemotherapy were retrospectively analyzed. Clinical efficacy and safety were assessed.
Results Among 21 patients, 15 cases were male and 6 female, aged 48 years on average (range, 21-72 years). All patients were classified as intermediate-and high-risk CMML according to the CMML-specific prognostic scoring system (CPSS). Sixteen patients (76.2%) achieved complete remission (CR) and 1 (4.8%) had marrow CR (mCR) after one course of decitabine combined with chemotherapy, with an overall response rate (ORR) of 81.0%. No treatment-related death was observed. The average follow-up duration was 18 months (range, 2 to 55 months). The median overall survival was 17.6 months. Eleven patients with a median age of 43 years (range, 21-53 years) received allogeneic hematopoietic stem cell transplantation (allo-HSCT) after three courses of joint regimen. They were followed up for 7-55 months. The median overall survival was 18 months. The recurrence rate was 9.1% after allo-HSCT (1/11).
Conclusions Decitabine combined with chemotherapy yields relatively high CR rate and excellent tolerance for patients with intermediate-and high-risk CMML.
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