This study was purposed to compare the clinical efficacy and adverse reactions of low-dose
decitabine combined with
CAG regimen (
aclarubicin,
Ara-C, and
G-CSF) and
CAG regimen alone in intermediate to high-risk
myelodysplastic syndromes (MDS), and evaluate the validity and efficacy of the former regimen as new treatment method of intermediate to high-risk
myelodysplastic syndromes. A total of 12 patients with intermediate (IR) to high-risk (HR) MDS treated by low-dose
decitabine combined with
CAG regimen and 10 patients with IR to HR MDS treated by
CAG regimen alone were evaluated
after treatment of 1 cycle and at least after 2 cycles. The complete remission (CR) after 1 cycle, overall remission rate (ORR), progression free survival (PFS) and overall survival (OS) between them were analyzed. The results showed that 9 patients treated by low-dose
decitabine combined with
CAG regimen achieved complete remission after 1 cycle, 2 patients achieved partial remission, 1 patient did not show reaction. The complete remission rate was 75.0% and overall response rate was 91.7%. The median time of disease free survival was 9 months (0-27 months). The median overall survival time was 16 months (3-28 months). 4 patients suffered from pulmonary
infection after treatment and then were all cured
after treatment with anti-infective
therapy. The 5 patients treated by
CAG regimen alone achieved complete remission,3 patients achieved partial remission, 2 patients showed non-reaction. The complete remission rate was 50.0% and overall response rate was 80.0%. The median time of disease free survival was 6 months(0-18 months). The median overall survival time was 13 months(3-31 months), 4 patients suffered from pulmonary
infection, 1 patient suffered from enteric
infection and 1 patient suffered from Escherichia coli
septicemia after treatment, all of them becomed better after active treatment. Two groups of patients all had no serious adverse reactions, All patients could tolerate, no severe complication-related death occurred in them. The statistical analysis indicated that the patients treated with low-dose
decitabine combined with
CAG regimen had longer progression free survival time than those treated with
CAG regimen alone, and had longer overall survival time but did not have statistically significant. It is concluded that low-dose
decitabine combined with
CAG regimen has better clinical efficacy for patients with intermediate to high-risk MDS and did not increase risk for them. It is worth to apply in clinic.