地西他滨联合抗CD33单抗治疗难治性急性髓细胞性白血病(附2例报告)  

Treatment of Refractory Acute Myeloid Leukemia with Decitabine Combined with Gemtuzumab Ozogamicin:A Report of 2 Cases

作　　者：唐晓文[1] 魏孝艾[1] 孙爱宁[1] 陈峰[1] 胡晓慧[1] 颜灵芝[1] 韩悦[1] 顾斌[1] 沈文红[1] 吴德沛[1] 

机构地区：[1]苏州大学附属第一医院血液科江苏省血液研究所卫生部血栓与止血重点实验室,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2011年第2期272-275,共4页Suzhou University Journal of Medical Science

基　　金：江苏省"科教兴卫"工程医学重点人才资助项目(RC2007072);江苏省人事厅"六大人才高峰"资助项目(07-B-019);苏州市国际科技合作项目(SWH0815);苏州市科技计划应用基础项目(YJS0912)

摘　　要：目的探讨地西他滨(DAC)联合抗CD33单抗(GO)治疗难治性急性髓细胞性白血病(AML)的疗效和安全性。方法对2例难治性AML(M4)患者均进行1个疗程的DAC联合GO治疗(具体剂量为DAC:20 mg.m-2.d-1×5 d,第1～5天,GO 9 mg/m2,第6天),应用骨髓涂片、定期监测血常规评价其疗效。结果经过1个疗程的DAC联合GO治疗后,1例患者未出现疾病进展,骨髓中原幼细胞由35%降至27.5%,巨核细胞由2个/片增加至(200个/片,血小板由减少改善为数量基本正常,临床上血小板恢复正常水平,一般情况良好。另1例在治疗期间高白细胞得以控制,治疗后第15天复查骨髓提示原幼细胞由38.5%降至12.5%,获得部分缓解。2例患者均未出现肝静脉闭塞病(VOD)及其他脏器功能损害表现。结论 DAC联合GO治疗难治性AML安全可行,尤其是对于一般情况差、不能耐受高剂量化疗或高剂量挽救化疗失败的患者,不失为一种新的治疗选择。Objective To investigate the efficacy and safety of treatment with decitabine（DAC） combined with gemtuzumab ozogamicin（GO） for refractory acute myeloid leukemia（AML） patients.Methods Two refractory AML（M4） patients were treated with DAC at a dose of 20 mg·m-2·d-1 for 5 days followed by GO at a dose of 9 mg/m2 for 1 day.The bone marrow smear,blood routine test were used to evaluate the efficacy of the treatment.Results After a course of DAC combined GO treatment,1 patient was stable without disease progression,such as blast cells of bone marrow declined from 35% to 27.5%,the number of megakaryocyte increased from 2/slide to 200/slide and platelet recovered.Hyperleukocytosis was controlled in another 1 patient during the treatment.Ths patient achieved partial remission（PR） with blast cells of bone marrow declining from 38.5% to 12.5%.There were neither veno-occulsive disease of the liver（VOD） nor other organ dysfunction presence in 2 cases.Conclusion Treatment of refractory AML with DAC combined with GO were effective and feasible.It may be considered as a new treatment option,especially for the patients with poor general performance,or can not tolerate high dose chemotherapy or have no response to intensive salvage chemotherapy.

关 键 词：地西他滨 抗CD33单抗 难治性 急性髓细胞性白血病 

分 类 号：R733.710.5[医药卫生—肿瘤]