To analyze the overall survival of patients with myelodysplastic syndrome treated with oral arsenic-containing compound Qinghuang Powder and to explore the factors affecting the overall survival of these patients.

A total of 170 patients with myelodysplastic syndrome who received treatment of compound Qinghuang Powder at our hospital were followed by phone calls or outpatient visits from January 2015 to October 2016. The deadline of the follow-up time was April 1, 2018. The primary outcome was the overall survival of patients. Kaplan-Meier analysis was used for descripting survival data and single variable analysis was used for prognostic factor analysis. Log-rank test was used for survival distribution comparison in different subgroups according to the prognostic factor. Non-parametric test was used for median overall survival comparison in different subgroups. Chi-square test was used for survival rate comparison in different subgroups.

The median overall survival of 170 patients with myelodysplastic syndrome was 54 months, and the 1-, 3-, 5-, and 10-year overall survival rates were 100%, 85.88%, 38.23%, and 5.88%, respectively. Of the 44 patients with excess blasts, the proportion of excess blasts decreased in 13 patients. Of all 170 patients, there were only 2 patients with excess blasts progressing to acute myeloid leukemia. When the effects of various factors on median overall survival were analyzed, the results showed that the median overall survival was significantly longer in patients aged ≤ 60 years old (55 months) than in those>60 years old (47 months, χ²=4.576, P=0.032), in female patients (55 months) than in male patients (47 months, χ²=6.166, P=0.013), and in patients with very good/good karyotype (57 months) than in those with moderate karyotype (43 months, χ²=4.133, P=0.042). When the effects of various factors on the annual overall survival rate were analyzed, the results showed that the 3-year overall survival rate of patients aged ≤ 60 years old was significantly higher than that of patients > 60 years old (χ²=6.98, P=0.01), and the 5-year overall survival rate of female patients was significantly higher than that of male patients (χ²=6.98, P=0.01). The 3- and 5-year overall survival rates were the highest in patients with good/very good karyotype, followed by patients with poor/very poor karyotype, and the lowest in patients with moderate karyotype (χ²=6.952, P=0.031; χ²=6.239, P=0.044). IPSS-R risk had no significant effect on the 1-, 3-, 5-, and 10-year survival rates (P>0.05).

Oral arsenic-containing compound Qinghuang Powder could improve the long-term overall survival of patients with myelodysplastic syndrome. Patients with very-high-risk/high-risk myelodysplastic syndrome can still benefit from the treatment of compound Qinghuang Powder.