Outcome of patients with myelodysplastic syndrome after failure of decitabine therapy

BACKGROUND: The prognosis of patients with myelodysplastic syndrome (MDS) after decitabine failure is not known. METHODS: Data from 87 patients with MDS (n=67) and chronic myelomonocytic leukemia (n=.20) after failure of decitabine regimens were reviewed. RESULTS: After a median follow-up of 21 months from decitabine failure, 13 (15%) patients remained alive; the median survival was 4.3 months, and the estimated 12-month survival rate was 28%. The estimated 12-month survival rates were 27%, 33%, and 33%, respectively, for patients with high-risk, intermediate-2-risk, and intermediate-1-risk disease (P=.99) by the International Prognostic Scoring System. The estimated 12-month survival rates were 100%, 54%, 41%, and 18%, respectively, for patients with low-risk, intermediate-1-risk, intermediate-2-risk, and high-risk disease according to The University of Texas M. D. Anderson Cancer Center risk model (P=.01). CONCLUSIONS: The outcome of patients after decitabine failure is poor and appears to be predictable after decitabine failure.