小剂量地西他滨联合亚砷酸治疗老年相对高危骨髓增生异常综合征的疗效  

Effect of low-dose decitabine combined with arsenic trioxide in the treatment of elderly patients with relatively high-risk myelodysplastic syndromes

作　　者：张诚[1] 万鼎铭[2] 曹伟杰[2] 党惠兵[1] 魏玉静[1] Zhang Cheng;Wan Dingming;Cao Weijie;Dang Huibing;Wei Yujing(Department of Hematology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China;Department of Hematology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]南阳医学高等专科学校第一附属医院血液科,河南南阳473000 [2]郑州大学第一附属医院血液科,450052

出　　处：《中国实用医刊》2018年第20期109-111,共3页Chinese Journal of Practical Medicine

基　　金：河南省高等学校重点科研项目计划（18A320040）

摘　　要：目的 探讨小剂量地西他滨联合亚砷酸治疗老年高危骨髓增生异常综合征（MDS）的疗效.方法 选择2014年10月至2017年12月南阳医学高等专科学校第一附属医院和郑州大学第一附属医院住院的年龄〉65岁的47例高危MDS患者,按照国际预后积分系统IPSS评分将其分为中危Ⅱ组26例和高危组21例,两组均使用小剂量地西他滨联合亚砷酸方案治疗,10 d为一疗程,4个疗程后评估疗效.结果 47例均完成4个疗程治疗,总有效率为85.1％,总完全缓解（CR）率为29.8％.中危Ⅱ组和高危组有效率分别为88.5％和81.0％,CR率分别为34.6％和23.8％,差异未见统计学意义（P〉0.05）;中危Ⅱ组2a存活率（39.9％）高于高危组（25.2％）,差异有统计学意义（P〈0.05）;中危Ⅱ组血液毒性反应发生率（57.6％）、感染发生率（65.4％）、水肿发生率（26.9％）与高危组（61.9％、66.7％、28.6％）比较,差异未见统计学意义（P〉0.05）.结论 小剂量地西他滨联合亚砷酸治疗老年相对高危MDS安全有效,尤其对中危Ⅱ组患者有较好的生存改善效果.Objective To investigate the effect of low-dose decitabine combined with arsenic trioxide on elderly patients with relatively high-risk myelodysplastic syndromes .Methods Forty-seven patients 〉65 years old with relatively high-risk myelodysplastic syndromes from October 2014 to December 2017 in the First Affiliated Hospital of Nanyang Medical College and the First Affiliated Hospital of Zhengzhou University were divided into intermediate-risk-Ⅱgroup （ n=26） and high-risk group （ n=21） in accordance with International Prognostic Scoring System （ IPSS ） score.The two groups were treated low-dose decitabine combined with arsenic trioxide , 10 days as a course , to assess the efficacy after 4 courses .Results All patients accomplished 4 courses , the total effective rate was 85.1％, the total CR rate was 29.8％.The effective rates of intermediate-risk-Ⅱgroup and high-risk group were 88.5％ and 81.0％;CR rates were 34.6％and 23.8％, the differences were not statistically significant （ P〉0.05 ）;the 2-year survival rate of intermediate-risk-Ⅱgroup （ 39.9％） was higher than that of high-risk group （25.2％）, the diffierence was statistically significant （P〈0.05）;there were no significant differences in hematological toxicity , infection, edema incidence between intermediate-risk-Ⅱgroup （57.6％, 65.4％, 26.9％） and high-risk group （61.9％, 66.7％, 28.6％） , the diffierence were not statistically significant （ P〉0.05） .Conclusions The treatment of low-dose decitabine combined with arsenic trioxide is safe and effective , in particular , patients in the intermediate-risk group II have better survival improvement .

关 键 词：地西他滨 亚砷酸 老年 骨髓增生异常综合征 

分 类 号：R551.3[医药卫生—血液循环系统疾病]