地西他滨治疗复发难治性急性髓系白血病的效果和安全性观察
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摘要
目的探讨地西他滨治疗复发难治性急性髓系白血病(AML)的临床疗效及安全性。方法选取32例复发性或难治性AML患者作为研究对象,采用地西他滨联合HAG方案治疗,治疗2个疗程后评价疗效及治疗安全性,随访观察患者的远期疗效。结果治疗2个疗程后,32例患者中CR 5例,PR 7例,NR 20例,总缓解率为37.50%,核型为良、中等、不良患者的缓解率依次降低(P<0.05)。WBC减少、PLT减少及胃肠不适的发生率较高,分别为100.00%、93.75%、93.75%,其次为肝肾损伤和感染。治疗后随访2年,32例患者中死亡28例,存活4例,死亡患者的生存时间为2.2~21.8个月,平均(8.1±1.6)个月。结论地西他滨联合HAG方案治疗复发性、难治性AML,早期治疗缓解率不高,药物不良反应明显,远期疗效不佳。
Objective To explore the clinical efficacy and safety of decitabine in the treatment of relapsed and refractory acute myeloid leukemia(AML). Methods 32 cases of relapsed or refractory AML patients were selected as research objects. All cases were treated with decitabine combined with HAG regimen. The efficacy and safety of treatment were evaluated after 2 weeks of treatment. All patients were followed up to observe the long-term efficacy. Results After 2 weeks of treatment, the overall remission rate was 37.50%, with 5 cases of CR, 7 cases of PR and 20 cases of NR; The remission rates of patients with good, moderate and bad karyotype decreased successively(P<0.05). The incidences of WBC reduction, PLT reduction and gastrointestinal discomfort were 100.00%, 93.75% and 93.75% respectively,following by liver/kidney injury and infection. During 2 years' follow-up, 28 cases were dead and 4 cases were survival; The survival time of death cases was 2.2 ~ 21.8 months, with the mean time of(8.1 ± 1.6) months. Conclusions Decitabine combined with HAG regimen in the treatment of relapsed and refractory AML has low early remission rate, obvious adverse drug reactions and poor long-term efficacy.
Objective To explore the clinical efficacy and safety of decitabine in the treatment of relapsed and refractory acute myeloid leukemia(AML). Methods 32 cases of relapsed or refractory AML patients were selected as research objects. All cases were treated with decitabine combined with HAG regimen. The efficacy and safety of treatment were evaluated after 2 weeks of treatment. All patients were followed up to observe the long-term efficacy. Results After 2 weeks of treatment, the overall remission rate was 37.50%, with 5 cases of CR, 7 cases of PR and 20 cases of NR; The remission rates of patients with good, moderate and bad karyotype decreased successively(P<0.05). The incidences of WBC reduction, PLT reduction and gastrointestinal discomfort were 100.00%, 93.75% and 93.75% respectively,following by liver/kidney injury and infection. During 2 years' follow-up, 28 cases were dead and 4 cases were survival; The survival time of death cases was 2.2 ~ 21.8 months, with the mean time of(8.1 ± 1.6) months. Conclusions Decitabine combined with HAG regimen in the treatment of relapsed and refractory AML has low early remission rate, obvious adverse drug reactions and poor long-term efficacy.
引文
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[9]吴思静,杨时佳,张恒,等.复发难治性急性髓系白血病临床高危因素分析及再诱导方案疗效评估[J].白血病·淋巴瘤,2014,23(11):677-680.
[2]唐元艳,熊涛,梁艳,等.地西他滨联合减量HAD方案治疗复发难治性急性髓系白血病临床观察[J].中国现代医学杂志,2015,25(32):75-77.
[3]中华医学会血液学分会.急性髓系白血病(复发难治性)中国诊疗指南(2011年版)[J].中华血液学杂志,2011,32(12):887-888.
[4]王涛,马梁明,朱秋娟,等.改良FLAG与CAG方案对复发难治性急性髓系白血病的疗效对比研究[J].中华血液学杂志,2014,35(11):966-969.
[5]范翠华,俞文娟,麦文渊,等.HAA方案治疗复发难治性急性髓系白血病64例疗效观察[J].中华血液学杂志,2016,37(2):100-104.
[6]曹翊雄,李君君,罗泽宇,等.改良FLAG与HAA方案治疗复发难治性急性髓系白血病疗效的对比研究[J].中国现代医学杂志,2016,26(11):72-76.
[7]陈峰,王景霞,侯明,等.吡柔比星为主联合化疗治疗复发难治性急性髓系白血病的多中心随机对照临床研究[J].中华血液学杂志,2014,35(5):388-392.
[8]梁艳,唐元艳,熊涛,等.地西他滨联合减量MA/DA方案治疗复发难治性急性髓系白血病临床观察[J].海南医学,2016,27(13):2101-2103.
[9]吴思静,杨时佳,张恒,等.复发难治性急性髓系白血病临床高危因素分析及再诱导方案疗效评估[J].白血病·淋巴瘤,2014,23(11):677-680.