氯法拉滨、阿糖胞苷联合或单用治疗成年骨髓增生异常综合征和急性白血病患者临床效果Meta分析  

Clinical efficacy of combined or single use of clofibrate and cytarabine in treatment of adult patients with myelodysplastic syndromes or acute leukemia:a Meta analysis

作　　者：刘飞飞 王彦 陈荣 沈建箴[1] Liu Feifei;Wang Yan;Chen Rong;Shen Jianzhen(Department of Hematology,Fujian Institute of Hematology,Fujian Provincial Key Laboratory on Hematology,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建省血液病研究所福建省血液病学重点实验室福建医科大学附属协和医院血液内科,福州350001

出　　处：《白血病．淋巴瘤》2019年第3期164-168,共5页Journal of Leukemia & Lymphoma

基　　金：福建省医学创新项目(2017-CX-16);福建省环保科技厅创新项目(2015R011);福建省高校产学研合作项目(2018Y4004);福建省血液医学中心资助项目(2011702#).

摘　　要：目的探讨氯法拉滨和阿糖胞苷联合用药及单独用药对成年骨髓增生异常综合征(MDS)和急性白血病患者的临床疗效。方法以氯法拉滨联合阿糖胞苷为联合组,以单用氯法拉滨或阿糖胞苷为对照组。通过计算机检索PubMed、CochranceLibrary、Embase和中国知网、万方、维普数据库中所有关于氯法拉滨、阿糖胞苷的文献,并进行数据提取。比较两组间临床疗效及安全性。结果纳入4篇文献,共计593例患者。联合组完全缓解率较对照组高[33.1%(93/281)比18.2%(35/192)],差异有统计学意义(RR=1.85,95%CI1.31~2.60,P<0.01)。联合组总体反应率较对照组高[44.0%(124/282)比23.2%(46/198)],差异有统计学意义(RR=1.92,95%CI1.44~2.56,P<0.01)。联合组皮肤不良反应发生率也高于对照组[38.8%(104/268)比3.1%(6/192)],差异有统计学意义(RR=7.76,95%CI3.68~16.38,P<0.01)。结论成年MDS和急性白血病患者应用氯法拉滨与阿糖胞苷联合化疗较单药应用有更好的临床疗效,但同时也有更严重的皮肤不良反应。Objective To analyze the clinical efficacy of combined or single use of clofibrate and cytarabine in the treatment of adult patients with myelodysplastic syndromes(MDS) or acute leukemia(AL).Methods Clofarabine combined with cytarabine was used in the combined group and clofarabine or cyarabine alone was used in the control group.All the studies about cytarabine and clofarabine were searched in PubMed,Cochrance Library,Embase,CNKI,Wanfang and VIP database by computer,and then the data was extracted.Results The complete remission rate of the combined group was higher than that of the control group [33.1%(93/281) vs.18.2%(35/192),and the difference was statistically significant (RR = 1.85,95% CI 1.31-2.60,P < 0.01).The overall response rate of the combined group was higher than that of the control group [44.0%(124/282) vs.23.2%(46/198)],and the difference was statistically significant (RR = 1.92,95% CI 1.44-2.56,P < 0.01).However,the incidence of skin adverse reactions in the combined group was also higher than that in the control group [38.8%(104/268) vs.3.1%(6/192)],and the difference was statistically significant (RR = 7.76,95% CI 3.68-16.38,P < 0.01).Conclusion The combination of clofarabine and cytarabine in the treatment of adult patients with MDS or AL has better clinical efficacy than single application,but it also has more serious skin adverse reactions.

关 键 词：骨髓增生异常综合征 急性白血病 成年人 氯法拉滨 阿糖胞苷 META分析 

分 类 号：R733.71[医药卫生—肿瘤] R551.3[医药卫生—临床医学]