减低剂量的地西他滨治疗骨髓增生异常综合征-难治性血小板减少  

Myelodysplastic syndrome-refractory thrombocytopenia treated by dose-reduced decitabine

作　　者：刘真真[1] 何广胜[1] 吴德沛[1] 孙爱宁[1] 仇惠英[1] 苗瞄[1] 王秀丽[1] 方宝枝[1] 吴倩[1] 常伟荣[1] 陈子兴[1] 阮长耿[1] 

机构地区：[1]苏州大学附属第一人民医院江苏省血液病研究所卫生部血栓与止血重点实验室,江苏苏州215006

出　　处：《临床血液学杂志》2013年第2期165-167,170,共4页Journal of Clinical Hematology

基　　金：国家科技支撑计划(No:2008BAI61B02);国家科技重大专项课题(No:2008ZX09312-026);江苏高校优势学科建设工程资助项目;高校自然科学研究项目(No:09KJB320015);苏州市社会发展及医药项目(No:SS08024);江苏省临床医学中心(No:ZX201102)

摘　　要：目的:总结减低剂量的地西他滨治疗3例骨髓增生异常综合征-难治性血小板减少(MDS-RT)患者的诊疗体会。方法:起始3例患者均行减低剂量地西他滨治疗1疗程:20mg/m2,静脉滴注1h,qd×3d,之后患者2巩固3疗程,患者3转用免疫抑制剂治疗。结果:1疗程结束后,患者1血小板3×109/L升为50×109/L,患者2血小板5×109/L升为45×109/L,均脱离输注,患者3仍未脱离输注,免疫抑制剂治疗无效,后进展为急性单核细胞白血病。结论:减低剂量地西他滨治疗低危的MDS-RT可改善血小板减少、血小板输注依赖问题,且不良反应少,值得在大样本的临床实验中检验其疗效。Objective：To summarize the experience of dose-reduced decitabine in treating 3 patients with myelodysplastic syndrome-refractory thrombocytopenia（MDS-RT）. Method：Dose-reduced decitabine was used to treat 3 patients with MDS-RT for the first course：20 mg/m2,iv 1 h,qd×3 d.Then No.2 patient went on to get decitabine-treatment for 3 courses and No.3 patient chose immunosuppressive therapy. Result：The platelet count of No.1 patient increased from 5×109/L to 45×109/L after one course treatment and the platelet count of No.2 patient increased from 5×109/L to 45×109/L.These two patients both got rid of platelet transfusion and the count of platelet was stable in the following 6 months.No.3 Patient still depended on platelet transfusion and transformed into AML-M_5 in the next 5 months. Conclusion：Dose-reduced decitabine treating MDS-RT may ameliorate platelet transfusion dependence and thrombocytopenia,while its side-effect is not serious.Moreover,the efficiency of decitabine need to be tested in large sample study.

关 键 词：骨髓增生异常综合征-难治性血小板减少 地西他滨 减低剂量 

分 类 号：R551.3[医药卫生—血液循环系统疾病]