低剂量地西他滨对老年MDS患者可溶性CD44、GDF11水平及造血功能的影响  

Effects of Low-Dose Decitabine on Soluble CD44, GDF11 Levels and Hematopoietic Function in Elderly Patients with MDS

作　　者：郭素青[1] 石锐[1] 陈园园[1] 刘珊[1] 李英华[1] GUO Su-Qing;SHI Rui;CHEN Yuan-Yuan;LIU Shan;LI Ying-Hua(Department of Hematology,Hengshui Harrison International Peace Hospital,Hengshui 053000,Hebei Province,China)

机构地区：[1]衡水市哈励逊国际和平医院血液科,河北衡水053000

出　　处：《中国实验血液学杂志》2019年第2期509-514,共6页Journal of Experimental Hematology

基　　金：河北省2017年度医学科学研究重点课题计划(20171220)

摘　　要：目的:探讨低剂量地西他滨对老年骨髓增生异常综合征(MDS)患者血清可溶性CD44与GDF11水平及造血功能的影响。方法:2015年10月至2017年10月本院收治的老年骨髓增生异常综合征(MDS)患者99例,随机分为A、B、C 3组,每组各33例。A组采用低剂量地西他滨治疗,B组采用常用剂量地西他滨治疗,C组采用低剂量地西他滨联合G-GSF、阿糖胞苷、阿克拉霉素治疗。治疗结束后,比较3组患者治疗前、后血清可溶性CD44,GDF11水平和造血功能指标(sTfR/E)变化情况,分析3组患者临床缓解率及不良反应发生率。结果:治疗前,3组患者血清可溶性CD44、GDF11以及sTfR/E水平比较无统计学差异(P>0.05)。治疗结束后,3组患者血清CD44及GDF11水平显著下降,而sTfR/E水平显著上升,3组间比较无统计学差异(P>0.05)。治疗后,A、B、C 3组总缓解率分别为84.8%、81.8%和78.8%,经比较差异无统计学意义(P>0.05)。治疗期间,在非血液毒性不良反应发生率中A组为9.1%,显著低于B组和C组的30.3%和27.3%(P<0.05,P<0.05);在血液毒性不良反应中A组为39.4%,显著低于B组和C组的63.7%和53.7%(P<0.05、 P<0.05)。结论:单用低剂量地西他滨治疗老年MDS患者相较于常规剂量及联合治疗方式,其临床疗效一致,且显著降低患者可溶性CD44和GDF11的水平,而且患者造血功能有改善,不良反应发生低,因而可作为临床治疗MDS的新选择。Objective:To investigate the effects of low-dose decitabine on levels of soluble CD44 and GDF11,and hematopoietic function in elderly patients with myelodysplastic syndrome(MDS).Methods:Ninety-nine patients with senile myelodysplastic syndrome(MDS)admitted to our hospital from October 2015 to October 2017 were divided into group A,B and C according to their treatment,each with 33 cases.The patients in group A were treated with low-dose decitabine,the patients in group B were treated with usual dose of decitabine,and the patients in group C were treated with low-dose decitabine plus G-GSF,cytarabine,and aclarithromycin.The changes of soluble CD44,GDF11 levels and hematopoietic function(sTfR/E)were compared before and after treatment.The clinical remission rate and adverse reaction rate in 3 groups were analyzed.Results:Before treatment,the levels of CD44,GDF11 and sTfR/E were not significantly different between the 3 groups(P>0.05).After treatment,the levels of CD44 and GDF11 were significantly decreased in these groups,while the serum levels of sTfR/E were significantly increased,and there was no significant difference between the 3 groups(P>0.05).After treatment,the total effective rates of A,B,and C 3 group were 82.3%,81.8%,and 78.8%,respectively,without statistically significant difference(P>0.05).During the treatment,the incidence of non-hemotoxic adverse reactions in group A was 8.8%,significantly lower than that in group B and C(30.3%,27.3%)(P<0.05,P<0.05),the incidence of hemotoxic adverse reactions in group A was 39.4%,significantly lower than that63.6% and 66.7% in group B and C(P<0.05,P<0.05).Conclusion:Low-dose decitabine alone is effective in treating elderly patients with MDS as compared with conventional dose and combination therapy,moreover can significantly reduce the levels of CD44 and GDF11,improve hematopoietic function and low the adverse reactions.Thereby the low dose of decitabine may be a new choice for clinical treatment of MDS.

关 键 词：地西他滨 骨髓增生异常综合征 CD44 GDF11 造血功能 

分 类 号：R551.3[医药卫生—血液循环系统疾病]