沙利度胺联合环孢素A治疗骨髓增生异常综合征的临床研究  

Clinical research of thalidomide combined wit CsA in treatment of MDS

作　　者：葛祥花[1] 

机构地区：[1]临沂市人民医院血液科,山东临沂276002

出　　处：《临床血液学杂志》2009年第3期256-258,共3页Journal of Clinical Hematology

摘　　要：目的:初步评价沙利度胺联合环孢素A治疗骨髓增生异常综合征的疗效与不良反应。方法:35例低危骨髓增生异常综合征患者,随机分为2组,分别接受了沙利度胺联合环孢素A(A组,n=18)或单用环孢素A(B组,n=17),比较2组的疗效和不良反应。结果:共24例患者取得血液学改善[A组16例(88.9%),B组8例(47%),P<0.05]。A组红系显效16例;血小板显效10例,微效4例;中性粒细胞显效10例,微效4例。B组红系显效6例,微效3例;血小板显效3例,微效3例;中性粒细胞显效4例,有效3例。A组15例依赖输血的患者中11例(73.3%)脱离输血,B组14例依赖输血的患者中5例(35.7%)脱离输血,2者疗效比较差异有统计学意义(P<0.05)。共9例患者出现肝功能异常[A组6例(33.3%),B组3例(21.4%),P>0.05)],3例出现肾功能异常[A组2例(11.1%),B组1例(7.1%),P>0.05],经停药或治疗后均好转。结论:联合环孢素A和沙利度胺治疗骨髓增生异常综合征疗效较单用环孢素A好,出现肝、肾功能异常是可逆的。Objective：To study the curative effect and side effect of thalidomide combined with CsA in treatment of MDS. Method：35 patients with MDS were treated with CsA as single agents（n= 17,group B ） or CsA combined with thalidomide （n= 18, group A）. Result.. Sixteen patients of group A（88.9%） and 8 patients of group B （47% P〈0.05） achieved hematologic improvement. 16 patients achieved HI-E,10 patients achieved HI- P（9 major, 1 minor） and 14 patients achieved HI-N（10 major, 4 minor） in group A. Nine patients achieved HI-E （6 major, 3 minor）, 6 patients achieved HI-P（3 major, 3 minor）and 7 patients achieved HI-N（4 major, 3mionr） in group B. 1 lpatients （11/15 cases, 73.3%） became transfusion independence in group A, while 5 patients （5/14 cases, 35.7%） became transfusion independence in group B. There was statistic difference between two groups （P〈0.05）. Nine patients emerged hepatic dysfunction（three in group B （21.4%）, six in groupA（33.3%） ,P 〉 0.05）. Three patients manifested renal function abnormality but all recovered after treatment. Conclusion： CsA combined while thalidomide is a highly effective and relatively well-tolerated treatment for patients with MDS.

关 键 词：骨髓增生异常综合征 沙利度胺 环孢素A 

分 类 号：R551.3[医药卫生—血液循环系统疾病]