摘要
目的:回顾性对比观察及分析地西他滨/阿扎胞苷分别联合HAAG(高三尖杉酯碱HTT、阿糖胞苷Ara-C、阿克拉霉素Acla及重组人粒细胞集落刺激因子G-CSF)治疗无法接受强化疗的老年急性髓系白血病患者的有效性和安全性。方法:回顾性分析我院2018年1月—2020年4月收治的33例老年急性髓系白血病患者,分为地西他滨组18例,方案为地西他滨+HAAG;阿扎胞苷组15例,方案为阿扎胞苷+HAAG。比较2组患者缓解率、毒副反应及生存情况。结果:治疗1个疗程后,地西他滨+HAAG组和阿扎胞苷+HAAG组总有效率分别为61.1%和60.0%,差异无统计学意义(P>0.05);2组在4个治疗周期后累积总有效率相当(66.7%vs 66.7%,P>0.05)。地西他滨+HAAG组和阿扎胞苷+HAAG组中位生存期分别为10.4个月和13.6个月,差异无统计学意义(P>0.05);中位无进展生存期分别为6.5个月和7.4个月,差异亦无统计学意义(P>0.05)。2组患者的主要不良反应为骨髓抑制和感染,在治疗过程中,接受地西他滨治疗的患者严重血液学不良事件的发生率略高,骨髓抑制期持续时间较长(P<0.05)。结论:地西他滨和阿扎胞苷均为治疗无法接受强化疗的老年急性髓系白血病患者的有效方案,两者总体有效率相近,阿扎胞苷有相对较低的毒副反应。
Objective: To compare the outcomes and securities of decitabine(DAC) or azacytidine(AZA) combined with HAAG regimen in the treatment of elderly patients with acute myeloid leukemia(AML) who cannot receive intensive chemotherapy. Methods: A total of 33 elderly AML patients were retrospective analyzed. Eighteen patients received DAC+HAAG induction chemotherapy treatment and 15 patients received AZA+HAAG induction chemotherapy treatment. Results: After 1 course of treatment, the overall response rates of DAC+HAAG group and AZA+HAAG group were 61.1% and 60.0%, respectively, with no significant difference(P>0.05). After 4 treatment cycles, the cumulative incidence of overall response in the two groups was similar(66.7% vs 66.7%, P>0.05). The median survival time of DAC+HAAG group and AZA+HAAG group was 10.4 months and 13.6 months, respectively, with no significant difference(P>0.05);the median progression free survival time was 6.5 months and 7.4 months, respectively, and there was no significant difference(P>0.05). During the treatment, the incidence of serious hematological adverse events in patients treated with DAC+HAAG was slightly higher and the duration of myelosuppression was longer(P<0.05). Conclusion: DAC and AZA are both effective options for the treatment of elderly patients with AML who can’t receive intensive chemotherapy. The overall effectiveness of the two groups is similar. AZA has relatively low adverse events.
作者
赵晓东
黄赛兰
郑雨雨
林国强
张兴霞
张彦明
ZHAO Xiaodong;HUANG Sailan;ZHENG Yuyu;LIN Guoqiang;ZHANG Xingxia;ZHANG Yanming(Department of Hematology,Huai’an Hospital Affiliated to Xuzhou Medical University,Huaian,223002,China)
出处
《临床血液学杂志》
CAS
2021年第1期35-40,共6页
Journal of Clinical Hematology
基金
江苏省卫计委面上项目(No:M2020058)
江苏省“333工程”项目(No:BRA2017246)
淮安市自然科学研究计划(No:HAB201814)
江苏省重点实验室开放课题(No:XZSYSKF2020038)。
作者简介
通信作者:张彦明,E-maihzhangyanming2005@126.com。
