低剂量地西他滨联合DA/MA方案对初次诱导失败的急性髓系白血病患者的疗效观察  

Effect of low dose decitabine combined with DA/MA regimen in initial induction failed patients with acute myeloid leukemia

作　　者：黄春晖[1] 万继兰[1] Huang Chunhui;Wan Jilan(Department of Hematology, Shanxian Central Hospital, Heze 274300, China)

机构地区：[1]黄春晖万继兰单县中心医院血液内科,菏泽274300

出　　处：《国际医药卫生导报》2019年第8期1257-1260,共4页International Medicine and Health Guidance News

摘　　要：目的探讨低剂量地西他滨联合DA/MA方案对初次诱导失败的急性髓系白血病(AML)患者的疗效。方法选取2015年1月至2018年6月初治未缓解急性髓系白血病患者96例(除外急性早幼粒细胞白血病).按非随机同期对照法分为观察组64例和对照组32例;对照组给予单独DA/MA方案再诱导治疗.观察组在此基础上联合低剂量地西他滨治疗.比较2种方案的完全缓解率、总有效率、2年生存率及不良反应「结果观察组完全缓解率65.6%,高于对照组43.8%,差异有统计学意义(P < 0.05 );观察组总有效率81.3%,高于对照组62.5%,差异有统计学意义(P < 0.05 ):观察组2年总生存率68.8%,高于对照组46.9%,差异有统计学意义(P < 0.05 );观察组出血率、感染率分别为53.1%、75.0%,均高于对照组31.3%、37.5%,差异均有统计学意义(均P < 0.05 )结论低剂量地西他滨联合DA/MA方案对初次诱导失败的AML缓解高,有利于患者长期生存,不良反应可以耐受,可以作为一线再诱导方案。Objective To explore the efficacy of low dose decitabine combined with DA/MA regimen in initial induction failed patients with acute myeloid leukemia (AML). Methods 96 AML patients with first induction failure in our hospital from January 2015 to June 2018 were divided into the observation group (64 cases) and the control group (32 cases) according to non-randomized concurrent control method. The control group was treated with DA/MA induction regimen again, the observation group was treated with decitabine on the basis. The therapeutic effects and adverse reactions were observed. Results The complete remission rate of the observation group and the control group were 65.6% and 43.8%(P<0.05), the overall response rates were 81.3% and 62.5% in the observation group and the control group (P<0.05), and the 2-year OS rates were 68.8% and 46.9% in the observation group and the control group, respectively (P<0.05). The rates of bleeding and infection of the observation group were higher than those of the control group (53.1% vs.31.3%, 75.0% vs.37.5%)(P<0.05). Conclusion Low dose decitabine combined with DA/MA regimen has significant therapeutic effect in initial induction failed patients with AML, safe and reliable, which can be used as a first-line reduction scheme.

关 键 词：急性髓系白血病 初次诱导失败 地西他滨 药物疗法 疗效 

分 类 号：R733.71[医药卫生—肿瘤]