小剂量地西他滨治疗中高危骨髓增生异常综合征效果及安全性评价
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摘要
目的:评价小剂量地西他滨治疗中高危骨髓增生异常综合征的效果及安全性。方法:选择笔者所在医院2013年1月-2015年1月收治的32例中高危骨髓增生异常综合征确诊患者作为研究对象,所有患者均给予静脉滴注小剂量地西他滨治疗,治疗后对患者进行随访,观察临床疗效、不良反应及预后。结果:本组32例患者共完成96个周期治疗,治疗总有效率为81.3%。所有患者治疗后均出现骨髓抑制反应,其中Ⅲ度骨髓抑制反应22例,Ⅳ度骨髓抑制反应10例,7例(21.9%)患者发生消化道反应,2例(6.3%)患者发生肺部感染,无心、肝、肾功能损害发生。对所有患者进行12个月的随访,其中死亡4例(12.5%),生存28例(87.5%),6例(18.8%)患者随访期内进展为急性白血病。结论:小剂量地西他滨治疗中高危骨髓增生异常综合征的疗效可靠,安全性较高,值得临床推广应用。
Objective:To evaluate the effect and safety of low dose of Decitabine in the treatment of high risk patients with marrow hyperplasia syndrome.Method:32 cases with marrow hyperplasia syndrome in our hospital were selected as the research object,all cases were given low-dose Decitabine treatment.After treatment,observed clinical effect,adverse reaction and prognosis.Result:32 patients completed 96 cycles of treatment,the total effective rate was 81.3%.All patients had bone marrow inhibition,in which Ⅲ degree bone marrow inhibition reactions of 22 cases,Ⅳ degree bone marrow inhibition reaction of 10 cases,7 cases(21.9%) occurred digestive tract reaction,2 cases(6.3%) occurred pulmonary infection,there was no function damage of liver and renal.All patients were followed up for 12 months,death in 4 cases(12.5%),alive in 28 cases(87.5%),occurred acute leukemia in 6 cases(18.8%) during follow-up period.Conclusion:Low dose of Decitabine in the treatment of high risk patients with marrow hyperplasia syndrome has good effect and high safety,and it is worthy of clinical application.
Objective:To evaluate the effect and safety of low dose of Decitabine in the treatment of high risk patients with marrow hyperplasia syndrome.Method:32 cases with marrow hyperplasia syndrome in our hospital were selected as the research object,all cases were given low-dose Decitabine treatment.After treatment,observed clinical effect,adverse reaction and prognosis.Result:32 patients completed 96 cycles of treatment,the total effective rate was 81.3%.All patients had bone marrow inhibition,in which Ⅲ degree bone marrow inhibition reactions of 22 cases,Ⅳ degree bone marrow inhibition reaction of 10 cases,7 cases(21.9%) occurred digestive tract reaction,2 cases(6.3%) occurred pulmonary infection,there was no function damage of liver and renal.All patients were followed up for 12 months,death in 4 cases(12.5%),alive in 28 cases(87.5%),occurred acute leukemia in 6 cases(18.8%) during follow-up period.Conclusion:Low dose of Decitabine in the treatment of high risk patients with marrow hyperplasia syndrome has good effect and high safety,and it is worthy of clinical application.
引文
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[10]赵龙,席亚明,郭敏,等.小剂量地西他滨治疗中高危骨髓增生异常综合征的Meta分析[J].肿瘤防治研究,2013,40(5):473-477.
[11]陈亚丽,郭荣,李英梅,等.低剂量地西他滨治疗中高危骨髓增生异常综合征患者38例疗效观察[J].中华实用诊断与治疗杂志,2016,30(6):620-622.
[12]吴涛,张忠强,于红涛.CAG方案治疗老年初治急性髓性细胞白血病疗效观察[J].中国医学创新,2015,12(22):121-122.
[13]梁亮,吴国才,聂丽容,等.减低剂量的地西他滨联合CAG方案治疗中高危骨髓增生异常综合征及难治性白血病的疗效[J].中国老年学杂志,2015,35(35):2073-2075.
[14]Cashen A,Schiller G,Larsen J S,et al.PhaseⅡstudy of low-dose decitabine for the first line treatment of older patients with acute myeloid leu-kemia(AML)[J].J Clin Oncol,2010,28(4):556-561.
[2]Nolte F,Hofnann W K.Molecular mechanisms involved in the progression of myelodysplastic syndromes[J].Future Oncol,2010,6(3):445-455.
[3]Jaffe E S,Harris N L,Stien H,et al.Pathology and genetics of tumours of haematopoietic and lymphoid tissues[M].Lyon,France:IARC Press,2001:61-73.
[4]Cheson B D,Greenberg P I,Bennett J M,et al.Clinical application and proposal for modification of the International Working Group(IWG)response criteria in myelodysplasia[J].Blood,2006,108(2):419-425.
[5]周学慧,肖志坚.国际工作组关于急性髓系白血病治疗试验的诊断、疗效标准的标准化、治疗结局和报告标准的修订建议[J].白血病·淋巴瘤,2004,13(4):246-250.
[6]张珠生.低幼稚细胞骨髓增生异常综合征患者细胞免疫表型特征研究[J].中国医学创新,2013,10(2):114-115.
[7]孟文俊,徐昕,戴秋新,等.CAG方案治疗中高危骨髓增生异常综合征疗效观察[J].山东医药,2011,51(25):89-90.
[8]张云平,吴文忠,崔国兴.地西他滨联合CAG方案与单纯CAG方案治疗中、高危骨髓增生异常综合征的疗效比较[J].中国实验血液学杂志,2014,22(5):1341-1344.
[9]谭振清,罗自勉,周新伏.低剂量地西他滨治疗骨髓增生异常综合征的疗效分析[J].现代肿瘤医学,2012,20(8):1682-1685.
[10]赵龙,席亚明,郭敏,等.小剂量地西他滨治疗中高危骨髓增生异常综合征的Meta分析[J].肿瘤防治研究,2013,40(5):473-477.
[11]陈亚丽,郭荣,李英梅,等.低剂量地西他滨治疗中高危骨髓增生异常综合征患者38例疗效观察[J].中华实用诊断与治疗杂志,2016,30(6):620-622.
[12]吴涛,张忠强,于红涛.CAG方案治疗老年初治急性髓性细胞白血病疗效观察[J].中国医学创新,2015,12(22):121-122.
[13]梁亮,吴国才,聂丽容,等.减低剂量的地西他滨联合CAG方案治疗中高危骨髓增生异常综合征及难治性白血病的疗效[J].中国老年学杂志,2015,35(35):2073-2075.
[14]Cashen A,Schiller G,Larsen J S,et al.PhaseⅡstudy of low-dose decitabine for the first line treatment of older patients with acute myeloid leu-kemia(AML)[J].J Clin Oncol,2010,28(4):556-561.