Stanozolol improves the progression-free survival of patients with high-risk myelodysplastic syndrome after decitabine treatment


It is unknown whether adding stanozolol to decitabine for maintenance can further improve progression-free survival (PFS) and overall survival (OS) after effective decitabine treatment in patients with high-risk myelodysplastic syndrome (MDS). Patients newly diagnosed with high-risk MDS who achieved at least partial remission after 4 cycles of decitabine (20 mg/m2 days 1–5) were selected. In total, 62 patients (median age 66 years) were enrolled, of whom 21 were treated with stanozolol and decitabine for maintenance, and 41 were treated with decitabine alone. The median number of cycles for maintenance treatment was 6 (2–11) and 5 (2–12) for the stanozolol and control groups, respectively (p > 0.05). PFS in the stanozolol group was significantly longer than in the control group (15.0 vs 9.0 months, hazard ratio [HR] = 0.35, 95%CI: 0.19–0.63, p = 0.0005), whereas OS was not significantly prolonged in the stanozolol group (21.0 vs 15.0 months, HR = 0.73, 95%CI: 0.39–1.37, p = 0.33). The proportion of patients with severe neutropenia during maintenance treatment in the stanozolol group was lower than in the control group (76.2% vs 95.1%, p = 0.039). In conclusion, adding stanozolol to decitabine after effective decitabine treatment can prolong PFS and reduce the severity of neutropenia for patients with high-risk MDS.

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This project is partly supported by The National Natural Science Foundation of China (nos. 81170472, 81970116, 81770118), Natural Science Foundation of Tianjin China (16JCZDJC35300), Key Technology Research and Development Program of Tianjin China (18ZXDBSY00140), Beijing Natural Science Foundation (7192168), the Chinese Academy of Medical Sciences (CAMS) innovation for medical sciences (2016-I2M-3-004).

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Correspondence to Huaquan Wang or Bing Han or Zonghong Shao.

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This project has been approved by the Ethics Committee, approval No. IRB2017-154-01. All patients or their relatives had to sign the informed consent before their data were recruited.

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Liu, Y., Yang, C., Xue, H. et al. Stanozolol improves the progression-free survival of patients with high-risk myelodysplastic syndrome after decitabine treatment. Int J Hematol (2021).

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  • Myelodysplastic syndrome
  • Stanozolol
  • Decitabine
  • Maintenance treatment