口服青黄散与低强度化疗治疗老年人急性髓系白血病生存情况比较  

Comparison of survival in elderly patients with acute myeloid leukemia treated with oral arsenic-containing Qinghuang Powder and low intensive chemotherapy

作　　者：吕妍[1] 刘为易 全日城[1] 肖海燕[1] 唐旭东[1] 刘驰[1] 李柳[1] 王洪志[1] 许勇钢[1] 郭小青[1] 范腾 胡晓梅[1] Lyu Yan;Liu Weiyi;Quart Richeng;Xiao Haiyan;Tang Xudang;Liu Chi;Li Liu;Wang Hongzhi;Xu Yonggang;Guo Xiaoqing;Fan Teng;Hu Xiaomei(Department of Hematology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School of China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院西苑医院血液科,北京100091 [2]中国中医科学院研究生院,北京100700

出　　处：《白血病．淋巴瘤》2018年第7期396-399,共4页Journal of Leukemia & Lymphoma

摘　　要：目的 探讨口服青黄散与低强度化疗治疗老年人急性髓系白血病（AML）的生存情况.方法 对2015年1月至2017年12月在中国中医科学院西苑医院接受治疗的42例老年AML患者临床资料进行回顾性分析,其中20例接受口服青黄散治疗（青黄散组）,22例接受低强度化疗（低强度化疗组）,比较两组患者的生存情况.结果 低强度化疗组和青黄散组中位生存期（13.0个月比13.5个月,χ^2=0.096,P=0.757）、1年生存率（59.1％比70.0％,χ^2=0.543,P=0.461）、2年生存率（13.6％比15.0％,χ^2=0.016,P＞0.05）、3年生存率（4.6％比5.0％,χ^2=0.005,P＞0.05）比较,差异均无统计学意义.分层分析显示,低强度化疗组和青黄散组年龄≥75岁（12个月比12.5个月,χ^2=1.317,P=0.251）、体能状况评分＞2分（12个月比12个月,χ^2=0.834,P=0.361）、继发AML（10个月比14个月,χ^2=1.552,P=0.213）、造血干细胞移植合并疾病指数＞2（12个月比13个月,χ^2=1.726,P=0.189）以及差的遗传学特征（12个月比8个月,χ^2=0.479,P=0.489）患者中位生存期比较,差异均无统计学意义.结论 口服青黄散与低强度化疗治疗老年AML患者的生存期相似.不愿接受低强度化疗的老年AML患者,尤其75岁以上患者,可以选择口服青黄散治疗.Objective To investigate the survival of oral arsenic-containing Qinghuang Powder （QHP） and low intensive chemotherapy （LIC） in the treatment of elderly patients with acute myeloid leukemia （AML）.Methods Forty-two AML patients older than 60 years in Xiyuan Hospital from January 2015 to December 2017 were retrospectively analyzed.Of them,20 cases were treated with QHP （QHP group）,22 cases were treated with LIC （LIC group）.The survivals of the two groups were compared.Results There was no significant difference of median survival time （13 months vs.13.5 months,χ^2 =0.096,P =0.757）,1-year survival rates （59.1% vs.70.0 %,χ^2 =0.543,P =0.461）,2-year survival rates （13.6 % vs.15.0 %,χ^2 =0.016,P 〉 0.05）,and 3-year survival rates （4.6 % vs.5.0 %,χ^2 =0.005,P 〉 0.05） between LIC and QHP groups.There was no significant difference of median survival time in age ≥75 year （12 months vs.12.5 months,χ^2 =1.317,P =0.251）,performance status scores 〉 2 （12 months vs.12 months,χ^2 =0.834,P =0.361）,hematopoietic stem cell transplantation with combined disease index 〉 2 （12 months vs.13 months,χ^2 =1.726,P =0.189）,secondary AML （10 months vs.14 months,χ^2 =1.552,P =0.213）,and poor cytogenetics （12 months vs.8 months,χ^2 =0.479,P =0.489） between LIC and QHP group.Conclusion The survival of elderly AML patients is considerable in patients treated with oral QHP and LIC,which suggests that oral QHP may be an equivalent alternative treatment since elderly AML （especially more than 75 years） patients refused to LIC therapy.

关 键 词：白血病 髓样 急性 青黄散 低强度化疗 老年人 

分 类 号：R733.71[医药卫生—肿瘤]