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Decitabine is used to treat myelodysplastic syndrome (MDS). This meta-analysis evaluated the efficacy and safety of different dosing regimens of decitabine in treating intermediate and/or high-risk MDS. Medline, Cochrane, EMBASE, and Google Scholar databases were searched up to October 23, 2015. Randomized controlled trials, prospective, cohort, and case series studies were included. Fifteen studies were included with a total of 1378 patients. The decitabine 100 mg/m 2 /course dosing regimen had a greater overall response rate than the 60-75 mg/m 2 /course (51 vs. 25%; P = 0.003). It also had higher complete response rate compared with the 135 mg/m 2 /course regimen (24.2 vs.13.7%; P = 0.016). The three dosing regimens were similar with respect to bone marrow complete response and partial response and hematologic improvement (P values > 0.05). Decitabine 135 mg/m 2 /course regimen had similar hematologic improvement as best supportive care (P = 0.066). The incidence of neutropenia, thrombocytopenia, infections, and anemia was similar across treatment groups (range, 31 to 38%; P values ≥ 0.899). The 100 mg/m 2 /course decitabine regimen showed benefit with respect to overall response rate compared with the 60-75 mg/m 2 /course regimen, as well as greater improvement in complete response rate compared with the 135 mg/m 2 /course regimen. All three dosing regimens had similar frequency of adverse events.

Purpose: Elderly acute myelocytic leukemia (AML) patients have limited treatment options because they poorly tolerate standard-dose chemotherapy. The present article describes our experience with ultra-low-dose decitabine combined with infusion of autologous cytokine-induced killer (CIK) cells for 2 elderly patients with myelodysplastic syndrome-transformed AML., Methods: Decitabine (10 mg) was given on days 1 to 5, and CIK cells on day 14 with 2 to 8 × 10(9) cells per infusion., Findings: The therapeutic regimen resulted in marked hematologic recovery and was associated with better than expected survival in both cases., Implications: Our experience suggests that the combination therapy is safe and effective for elderly patients with myelodysplastic syndrome-transformed AML., (Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.)