低剂量地西他滨联合半量CAG治疗老年急性髓系白血病的临床研究
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摘要
目的对比低剂量国产地西他滨联合半量CAG方案与CAG方案治疗老年急性髓系白血病的疗效及安全性。方法收集2015年2月至2018年6月在川北医学院第二临床医学院·南充市中心医院诊治的老年急性髓系白血病42例,其中22例作为试验组给予低剂量地西他滨联合半量CAG方案,20例作为对照组给予标准剂量CAG方案,比较两组患者的疗效及不良反应。结果试验组的总有效率(86.4%)高于对照组(55.0%),差异有统计学意义(P<0.05)。两组不良反应的表现及发生率相似,差异无统计学意义(P> 0.05)。结论低剂量国产地西他滨+半量CAG方案的总缓解率优于CAG方案,且不增加化疗相关风险,可作为老年急性髓系白血病的一线治疗方案。
Objective To compare the clinical efficacy and safety between the regimen of the low-dose decitabine combined with half-dose CAG and the CAG regimen in the treatment of elderly patients with acute myeloid leukemia(AML).Methods A total of 42 cases of elderly patients with AML treated in Nanchong Central Hospital from February of 2015 to June of 2018 were selected in the study.The expereiment group with 22 patients were treated with the regimen of low-dose decitabine combined with half-dose CAG,and the control group with the other 20 patients received the CAG regimen.Results The overall effective rate in the experiement group(81.8%)was significantly higher than that in control group(55.0%)(P<0.05).The manifestations and incidence of adverse reactions were not significantly different between both group(P>0.05).Conclusion The overall effective rate of the regimen of low-dose decitabine combined with half-dose CAG is higher than that of the CAG regimen without increasing the risks associated with chemotherapy,so it can be used as the first-line treatment regimen for elderly patients with AML.
Objective To compare the clinical efficacy and safety between the regimen of the low-dose decitabine combined with half-dose CAG and the CAG regimen in the treatment of elderly patients with acute myeloid leukemia(AML).Methods A total of 42 cases of elderly patients with AML treated in Nanchong Central Hospital from February of 2015 to June of 2018 were selected in the study.The expereiment group with 22 patients were treated with the regimen of low-dose decitabine combined with half-dose CAG,and the control group with the other 20 patients received the CAG regimen.Results The overall effective rate in the experiement group(81.8%)was significantly higher than that in control group(55.0%)(P<0.05).The manifestations and incidence of adverse reactions were not significantly different between both group(P>0.05).Conclusion The overall effective rate of the regimen of low-dose decitabine combined with half-dose CAG is higher than that of the CAG regimen without increasing the risks associated with chemotherapy,so it can be used as the first-line treatment regimen for elderly patients with AML.
引文
[1]李沛颖,宗志锋,董丽洁,等.参麦注射液联合DA化疗方案治疗老年急性髓系白血病40例临床观察[J].中医药导报,2013,19(8):46-48.
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[13]Lee J Y,Lee S M,Lee J Y,et al.Mixed-phenotype acute leukemia treated with decitabine[J].Korean J Intern Med,2016,31(2):406-408.
[14]邢丽娜,任金海,蔡圣鑫,等.地西他滨单药或联合预激方案治疗骨髓增生异常综合征及急性髓系白血病的临床分析[J].肿瘤,2015,35(5):544-549,591.
[15]于锦香,蔡冬梅,王晓雪,等.地西他滨联合CAG治疗老年急性髓系白血病的疗效观察[J].实用药物与临床,2013,16(3):211-213.
[16]崔文婷,胡苏,黄燕,等.地西他滨治疗老年急性髓系白血病的临床疗效[J].临床合理用药杂志,2016,9(9):77-79.
[17]Alizad Ghandforoush N,Chahardouli B,Rostami S,et al.Evaluation of minimal residual disease in acute myeloid leukemia with NPM1marker[J].Int J Hematol Oncol Stem Cell Res,2016,10(3):147-152.
[2]Estey E.AML in older patients:are we making progress[J].Best Pract Res Clin Haematol,2009,22(4):529-536.
[3]刘现民.地西他滨联合CAG方案治疗老年急性髓系白血病患者的效果与安全性分析[J].河南医学研究,2015,24(12):97-98.
[4]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:103-134.
[5]Kantarjian H,O'Brien S,Cortes J,et al.Results of intensive chemotherapy in 998patients age 65years or older with acute myeloid leukemia or high-risk myelodysplastic syndrome:[J].Cancer,2006,106(5):1090-1098.
[6]钟济华,陈芳源,王海嵘,等.CAG方案对急性髓系白血病细胞作用机制的研究[J].中华血液学杂志,2006,27(7):492-494.
[7]刘芳.CAG方案治疗初治老年急性髓系白血病的疗效观察[J].中国煤炭工业医学杂志,2012,15(6):846-847.
[8]陈懿建,张立群,李晓林,等.预激方案CAG治疗老年初治急性髓性细胞白血病的疗效[J].中南大学学报(医学版),2008,33(3):245-251.
[9]Nieto M,Demolis P,Béhanzin E,et al.The european medicines agency review of decitabine(dacogen)for the treatment of adult patients with acute myeloid leukemia:summary of the scientific assessment of the committee for medicinal products for human use[J].Oncologist,2016,21(6):692-700.
[10]Jing Y,Shen X,Mei Q,et al.Spotlight on decitabine for myelodysplastic syndromes in Chinese patients[J].Onco Targets Ther,2015,8(3):2783-2790.
[11]Cashen A F,Schiller G J,O'Donnell M R,et al.Multicenter,phase II study of decitabine for the first-line treatment of older patients with acute myeloid leukemia[J].JCO,2010,28(4):556-561.
[12]Mamdani H,Santos C D,Konig H.Treatment of acute myeloid leukemia in elderly patients-a therapeutic dilemma[J].J Am Med Dir Assoc,2016,17(7):581-587.
[13]Lee J Y,Lee S M,Lee J Y,et al.Mixed-phenotype acute leukemia treated with decitabine[J].Korean J Intern Med,2016,31(2):406-408.
[14]邢丽娜,任金海,蔡圣鑫,等.地西他滨单药或联合预激方案治疗骨髓增生异常综合征及急性髓系白血病的临床分析[J].肿瘤,2015,35(5):544-549,591.
[15]于锦香,蔡冬梅,王晓雪,等.地西他滨联合CAG治疗老年急性髓系白血病的疗效观察[J].实用药物与临床,2013,16(3):211-213.
[16]崔文婷,胡苏,黄燕,等.地西他滨治疗老年急性髓系白血病的临床疗效[J].临床合理用药杂志,2016,9(9):77-79.
[17]Alizad Ghandforoush N,Chahardouli B,Rostami S,et al.Evaluation of minimal residual disease in acute myeloid leukemia with NPM1marker[J].Int J Hematol Oncol Stem Cell Res,2016,10(3):147-152.