低剂量地西他滨联合CAG方案治疗老年骨髓增生异常综合征的临床疗效观察  

Analysis of the clinical efficacy of low-dose decitabine combined with half-dose CAG regimen on the elderly patients with high risk myelodysplastic syndrome

作　　者：孙青刚 郝代钧 李伟 王明辉 张海燕 Sun Qinggang;Hao daijun;Li Wei;Wang Minghui;Zhang Haiyan(Departmen of hematology,The PLA Navy No.971 Hospital,Qingdao 266071,China;Departmen of No.2 Internal Medicine,Qingdao Centre(Tumour)Hospital,Qingdao 266042,China)

机构地区：[1]解放军海军第九七一医院血液病科,青岛266071 [2]青岛市中心(肿瘤)医院内二科,青岛266042

出　　处：《中华转移性肿瘤杂志》2022年第3期241-244,共4页Chinese Journal of Metastatic Cancer

摘　　要：目的观察低剂量地西他滨联合半量CAG方案[小剂量阿糖胞苷(Ara-C)+阿柔比星(Acla)+重组人粒细胞集落刺激因子(G-CSF)]治疗老年中高危骨髓增生异常综合征(MDS)患者的近期临床疗效。方法选取2019—2020年间于解放军海军第九七一医院血液病科诊治23例老年中高危MDS患者为观察对象,均应用低剂量地西他滨联合半量CAG方案治疗,观察其临床疗效与不良反应。结果23例患者均为MDS伴原始细胞过多,均接受地西他滨平均剂量(13.5±1.45)mg/m^(2),CAG方案减半。疗后总有效率(ORR)为91%,其中完全缓解14例(61%),部分缓解2例(9%);3例(13%)骨髓完全缓解伴血液学改善,2例(9%)单纯血液学改善。高危染色体核型患者中ORR为82%(9/11),正常核型和其他核型ORR为100%。所有患者均出现骨髓抑制,18例(78%)为2~3级,5例(22%)为4级;15例(65%)患者出现化疗相关感染;16例(70%)出现1~2级消化道反应;2例(9%)出现转氨酶升高。结论低剂量地西他滨联合半量CAG方案治疗老年中高危MDS近期疗效和安全性均良好。Objective To observe the short-term clinical efficacy of low-dose decitabine combined with half-dose CAG regimen(low-dose cytarabine(Ara-C)+alarubicin(Acla)+recombinant human granulocyte colony-stimulating factor(G-CSF))in elderly patients with high risk myelodysplastic syndrome.Methods Frome 2019 to 2020,23 elderly high-risk MDS patients treated in department of hematology,the PLA Navy No.971 Hospital were selected as observation subjects,all of whom were treated with low-dose decitabine combined with half-dose CAG regimen,and the clinical efficacy and adverse reactions were observed.Results All the 23 patients were MDS with excessive blasts(MDS-EB1-2).Receiving an average dose of decitabine(13.5±1.45)mg/m^(2),CAG regimen was halved.After treatment overall remission rate(ORR)was 91%,including 14 cases(61%)complete remission(CR)and partial remission 2 cases(9%),marrow CR with Hematological improvement(HI)3 cases(13%),HI 2 cases(9%).ORR was 82%(9/11)in high-risk karyotypes,and 100%in normal karyotypes and other kayrotypes.All patients had myelosuppression,18 patients(78%)were grade 1-2 myelosuppression,5 patients(22%)had grade 4 myelosuppression,15 patients(65%)had chemotherapy related infections,16 patients(70%)had degree gastroin-testinal reaction.2 patients(9%)showed elevated transhydrogenase.Conclusions Low-dose decitabine combined with half-dose CAG in the treatment of elderly patients with high-risk myelodysplatic syndrome has achieved good short-term efficacy and safety.

关 键 词：骨髓增生异常综合征 地西他滨 CAG方案 

分 类 号：R73[医药卫生—肿瘤]