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Blood, 1 August 2007, Vol. 110, No. 3, pp. 1083. This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kantarjian, H. Articles by Issa, J.-P. Search for Related Content PubMed Articles by Kantarjian, H. Articles by Issa, J.-P. Related Collections Related Articles in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents CORRESPONDENCE Response: Decitabine response with chromosome 7 abnormality in MDS, and decitabine optimal schedule The observation of Rüter et al regarding the favorable response of patients with myelodysplastic syndrome (MDS) and chromosome 7 abnormalities to decitabine is interesting. We had previously analyzed the prognostic factors associated with decitabine therapy in our patients with higher risk MDS.1 We did not find an association between pretreatment cytogenetic abnormalities and response, but found, by multivariate analysis, that the presence of chromosome 5 or 7 abnormalities was associated with poor survival.1 Since this study classified the cytogenetic abnormalities slightly differently and correlated cytogenetic studies with complete cytogenetic response, we reanalyzed the data as reported by Ruter et al. This is summarized in Table 1. We could not confirm the positive effect of the presence of chromosome 7 abnormality with cytogenetic response on decitabine therapy. This may be due to differences in the study groups, the decitabine dose schedules, or the small number of patients involved in each of the 2 analyses. View this table: [in this window] [in a new window]   Table 1. Responses by IWG criteria   We agree with Dr Giagounidis' comments. The Bayesian randomization design allows for studies with smaller numbers of patients, but can be associated with higher rates of false-positive and false-negative results, depending on the operating characteristics of the design. In our study, we can firmly conclude that the decitabine 10-day intravenous schedule is unlikely to be more active, is definitely more cumbersome, and is likely associated with more toxicities.2 However, as stated in our discussion, the decitabine 5-day subcutaneous schedule may still be as effective as the decitabine 5-day intravenous schedule, and would offer an alternative delivery route. The concluding statement of Dr Giagounidis' letter sums it up well: a comparison of the decitabine (100 mg/m2 per course) 5-day intravenous versus 5-day subcutaneous schedule is needed but will require a larger comparative trial.    Authorship Top Authorship References   Conflict-of-interest disclosure: H.M.K. receives research grants from Novartis, Bristol Myers Squibb, and MGI Pharma; all other authors declare no competing financial interests. Correspondence: Hagop Kantarjian, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Box 72 0428, Houston, TX 77030; e-mail: hkantarj{at}mdanderson.org. Hagop Kantarjian, Xuelin Huang, and Jean-Pierre Issa    References Top Authorship References   Kantarjian H, O'Brien S, Shan J, et al. Update of the decitabine experience in higher risk myelodysplastic syndrome and analysis of prognostic factors associated with outcome. Cancer 2007; 109:265–273.[CrossRef][Medline] [Order article via Infotrieve] Kantarjian H, Oki Y, Garcia-Manero G, Huang X, et al. Results of a randomized study of three schedules of low-dose decitabine in higher risk myelodysplastic syndrome and chronic myelomonocytic leukemia. Blood 2007; 109:52–57.[Abstract/Free Full Text] CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Articles in Blood Online: Preferential cytogenetic response to continuous intravenous low-dose decitabine (DAC) administration in myelodysplastic syndrome with monosomy 7 Björn Rüter, Pierre Wijermans, Rainer Claus, Regina Kunzmann, and Michael Lübbert Blood 2007 110: 1080-1082. [Full Text] [PDF] Decitabine dosage in myelodysplastic syndromes Aristoteles A. N. Giagounidis Blood 2007 110: 1082-1083. [Full Text] [PDF] Results of a randomized study of 3 schedules of low-dose decitabine in higher-risk myelodysplastic syndrome and chronic myelomonocytic leukemia Hagop Kantarjian, Yasuhiro Oki, Guillermo Garcia-Manero, Xuelin Huang, Susan O'Brien, Jorge Cortes, Stefan Faderl, Carlos Bueso-Ramos, Farhad Ravandi, Zeev Estrov, Alessandra Ferrajoli, William Wierda, Jianqin Shan, Jan Davis, Francis Giles, Hussain I. Saba, and Jean-Pierre J. Issa Blood 2007 109: 52-57. [Abstract] [Full Text] [PDF] This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kantarjian, H. Articles by Issa, J.-P. Search for Related Content PubMed Articles by Kantarjian, H. Articles by Issa, J.-P. 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