地西他滨单药或联合CAG方案治疗高危骨髓增生异常综合征的疗效及安全性分析  

Clinical efficacy and safety of single drug of decitabine or combined CAG regimen in the treatment of high-risk MDS

作　　者：郑琳[1] 陈果 ZHENG Lin;CHEN Guo(Department of Hematology,Chengdu Third People s Hospital,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院血液科,四川成都610031

出　　处：《实用医院临床杂志》2018年第6期87-90,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨地西他滨(DAC)单药或联合阿克拉霉素+阿糖胞苷+粒细胞集落刺激因子(CAG)方案治疗高危骨髓增生异常综合征(MDS)的疗效及安全性。方法回顾性分析88例高危MDS患者临床资料,根据治疗方案分为联合组(n=43)和单药组(n=45)。单药组应用DAC,联合组应用DAC联合CAG方案。比较两组临床疗效,评估治疗前、治疗1个月后血常规[血红蛋白(Hb)、血小板计数(Plt)]、生存质量[生存质量测定量表简表(WHOQOL-BREF)],随访1年记录患者不良反应发生率及生存率。结果治疗1个月后,联合组总缓解率高于单药组(P <0. 05);两组血常规(Hb、Plt)水平、WHOQOLBREF评分中生理、心理2维度均高于治疗前,联合组高于单药组(P <0. 05);联合组疗程低于单药组(P <0. 05),两组1年生存率比较差异无统计学意义(P> 0. 05);两组中性粒细胞减少、肺部感染发生率比较差异无统计学意义(P> 0. 05),联合组骨髓抑制及血小板减少发生率高于单药组(P <0. 05)。结论 DAC联合CAG方案治疗高危MDS有利于提高临床疗效、缩短平均用药疗程,改善血常规指标水平和生存质量,但增加骨髓抑制及血小板减少发生风险。To explore the efficacy and safety of single drug of decitabine(DAC)or cytarabine+aclacinomycin+granulocyte colony-stimulating factor(CAG)in the treatment of high-risk myelodysplastic syndrome(MDS).The clinical data of 88 patients with high-risk MDS were retrospectively analyzed.The patients were divided into combined group(n=43)and single drug group(n=45)according to treatment regimens.The single drug group was given DAC,and the combined group was given DAC combined with CAG.The clinical efficacy was compared between the two groups.The blood routine indexes such as hemoglobin(Hb)and platelet count(Plt)and quality of life(WHO Quality of Life-BR)were evaluated before treatment and after 1 month of treatment.The incidence of adverse reactions and the survival rate were recorded after 1-year follow-up.After 1 month of treatment,total remission rate in the combined group was higher than that in the single drug group(P<0.05).The levels of blood routine indexes(Hb and Plt)and the scores of physiology and psychology of quality of life scale were higher than those before treatment in the both groups,and the improvements in the combined group was better than those in the single drug group(P<0.05).The treatment course in the combined group was shorter than that in the single drug group(P<0.05).There was no significant difference in the 1-year survival rate between the two groups(P>0.05).There was also no significant difference in the incidence rates of neutropenia and lung infection between the two groups(P>0.05).However,the incidence rates of myelosuppression and thrombocytopenia in the combined group were higher than those in the single drug group(P<0.05).DAC combined with CAG regimen for high-risk MDS is conducive to improve the clinical efficacy,shorten the average course of medication and improve the blood routine indexes and quality of life.However,it could increase the risk of myelosuppression and thrombocytopenia.

关 键 词：地西他滨 CAG方案 骨髓增生异常综合征 急性髓系白血病 

分 类 号：R551.3[医药卫生—血液循环系统疾病]