摘要
目的:对地西他滨联合预激方案和传统治疗方案治疗老年骨髓增生异常综合征(MDS)或骨髓增殖性疾病(MPD)转化的急性髓系白血病(AML)的有效性和安全性进行比较研究。方法:回顾性分析28例MDS/MPD转化的老年AML患者的临床资料,分别应用地西他滨联合预激方案11例和传统治疗方案17例(其中"3+7"标准方案8例、CAG方案6例及支持治疗3例),比较分析2组患者的临床疗效及不良反应。结果:地西他滨联合预激组中完全缓解(CR)7例(63.6%),未缓解(NR)4例(36.4%),总有效率(ORR)为63.6%;传统治疗组中CR 4例(23.5%),分别为"3+7"标准方案2例、CAG方案2例,NR 13例(76.5%),ORR为23.5%。地西他滨联合预激组的有效率明显高于传统治疗组,差异有统计学意义(P<0.05)。2组患者治疗前骨髓原始细胞数对于缓解与否无差异(P>0.05)。2组患者出现的不良反应主要是骨髓抑制、肺部感染、恶心呕吐、肝功能损害和心力衰竭,经过输血和抗感染等支持治疗均可以耐受,2组不良反应发生率比较差异无统计学意义(P>0.05)。随访至2013年9月,地西他滨联合预激组和传统治疗组的中位生存分别是15个月和2个月,差异有统计学意义(P<0.05)。结论:地西他滨联合预激方案治疗老年转化性AML患者的临床疗效显著,不良反应可以耐受,可作为老年转化性AML的首选方案。
Objective：To compare the clinical efficacy and safety between decitabine combined with priming regiment and traditionally therapeutic regiments in treating elderly MDS/MPD-transformed acute myeloid leukemia（AML）.Method：A total of 28elderly AML patients with antecedent hematologic disorders（MDS/MPD）were en-rolled.Eleven patients received decitabine combined with priming regimen and other 17patients received tradition-ally therapeutic regiments（including 8patients with ＂3＋7＂ regiment,6cases with CAG regiment and 3cases with supportive care）.We analyzed the difference of clinical outcomes and adverse reactions among the two groups.Re- sult：In decitabine treatment group,7patients achieved complete remission（CR）and 4cases had no response（NR）,with a total remission rate（ORR）of 63.6%;while in traditional therapy group,ORR was only 23.5%（4 cases achieved CR）,including 2patients with ＂3＋7＂ regimen and 2with CAG regimen.The ORR of decitabine group was significantly higher than that of traditional therapy group（P0.05）.Compared with those in non-CR patients,the marrow blast counts in CR patients had no significant difference in both decitabine treatment group and traditional therapy group（P0.05）.Adverse events in the two groups were similarly,mainly myelosuppres- sion,pulmonary infection,nausea,vomiting,liver injuryand heart failure could be well tolerated after managements（P〈0.05）.Followed-up to September 2013,the median overall survival of decitabine group and traditional therapy group was 15and 2months respectively（P〉0.05）.Conclusion：Decitabine combined with priming regimen is ef- fective and well tolerated in elderly transformed AML.
出处
《临床血液学杂志》
CAS
2014年第1期15-18,共4页
Journal of Clinical Hematology
基金
国家自然科学基金(No:81101793)
关键词
地西他滨
转化性
白血病
髓系
急性
老年
decitabine
transformed
acute myeloid leukemia
elderly patients
作者简介
通信作者：王黎，E-mail：wl_wangdong@126．com
