超小剂量地西他滨治疗骨髓增生异常综合征疗效分析  

Clinical therapeutic effect of ultra-low dose of decitabine in the treatment of myelodysplastic syndrome

作　　者：何国民[1] 陈婷[1] 徐娟[1] 蔡亚云[1] 贲海祥 何广胜[2] 李建勇[2] 

机构地区：[1]如皋市人民医院,江苏如皋226500 [2]江苏省人民医院南京医科大学第一附属医院

出　　处：《临床血液学杂志》2017年第3期380-382,共3页Journal of Clinical Hematology

基　　金：国家科技攻关项目(No:2014BAI09B12);卫生部科研基金(No:201202017);江苏省医学重点项目(No:BL2014086);江苏省普通高校优势学科(No:JX10231801)

摘　　要：目的:总结超小剂量地西他滨治疗骨髓增生异常综合征(MDS)临床疗效与安全性。方法:回顾性分析皮下注射地西他滨(5~7mg·m^(-2)·d^(-1),d1~3,8,15,22,6周为1个疗程)治疗16例MDS患者的疗效和不良反应。结果:2例(12.5%)获完全缓解,2例(12.5%)获部分缓解并脱离成分血输注,5例(31.3%)达血液学改善,5例(31.3%)病情稳定,总反应率87.5%。Ⅳ级血液学毒性发生率2例(12.5%),Ⅲ~Ⅳ级感染发生率4例(25.0%),无Ⅲ~Ⅳ级出血、恶心呕吐和肝功能损伤。中位随访时间15.5(6~27)个月,随访期间1例死亡。结论:超小剂量地西他滨可以有效治疗MDS,严重血液学毒性和早期病死发生率低。Objective：To evaluate the clinical efficacy and safety of ultra-low dose of decitabine in the treatment of patients with myelodysplastic syndrome （MDS）. Method：Sixteen patients with MDS were treated by a deeit- abine regimen （5 to 7 mg · m-2 · d-1 ,d1-3,8,15,22） per course every 6 weeks. The clinical characteristics and outcomes of 16 patients were retrospectively analyzed. The clinical efficacy and the parameters were evaluated be- tween the different prognosis groups. Result ： Two cases （ 12.5% ） achieved complete remission, 2 cases （ 12.5 % ） achieved partial remission and transfusion independence, 5 cases （31.3 %） achieved hematological improvement and 5 cases （31.3%） maintained stable disease. The total response rate was 87.5%. Grade IV of hematological toxicity and grade III to IV of infection happened in 2 cases （12.5%0） and 4 cases （25.0%）, respectively. No grade III to IV of hemorrhage, liver damage and gastrointestinal disorder. The median progress time was 15.5 （6 to 27） months, 1 case died during the follow-up period. Conclusion： The ultra-low dose of decitabine is effective for pa tients with MDS, with low hematologic toxicity and low early mortality.

关 键 词：骨髓增生异常综合征 地西他滨 超小剂量 

分 类 号：R733[医药卫生—肿瘤]