阿扎胞苷治疗老年中高危骨髓增生异常综合征的疗效和安全性分析  

Efficacy and Safety of Azacitidine in the Treatment of Middle-and-High-Risk Myelodysplastic Syndrome in the Elderly

作　　者：曾维斌 刘少平[2] 许家健 Zeng Weibin;Liu Shaoping;Xu Jiajian(Department of Oncology and Hematology,Xiaolan People's Hospital,Zhongshan City,Guangdong Province,528415,P.R.China;Department of Hemodialysis,Xiaolan People's Hospital,Zhongshan City,Guangdong Province,528415,P.R.China)

机构地区：[1]广东省中山市小榄人民医院(南方医科大学附属小榄人民医院)肿瘤血液科,广东中山528415 [2]广东省中山市小榄人民医院(南方医科大学附属小榄人民医院)血透室,广东中山528415

出　　处：《老年医学与保健》2019年第6期805-808,共4页Geriatrics & Health Care

摘　　要：目的探讨阿扎胞苷治疗老年中高危骨髓增生异常综合征(myelodysplastic syndrome,MDS)的疗效和安全性,以提供治疗MDS的有效方法。方法回顾性分析2017年2月-2019年2月来我院治疗的21例中高危老年骨髓增生异常综合征患者的临床资料,所有患者均给予75 mg/m2的阿扎胞苷进行治疗,1个疗程为28 d,通过分析评估治疗的疗效和安全性。结果 21例患者平均治疗时长为(5.05±1.89) d,平均治疗间隔时间为(25.77±5.23) d,平均随访时间为(137.27±73.45) d。18例患者均完成≥4个疗程治疗,患者总疗效率为38.89%(7/18);3例患者病情稳定;4例患者病情进展;2例患者病情复发;2例患者病情转变为急性髓细胞性白血病(acute myeloidleukemia,AML)。21例患者均出现不同程度的粒细胞下降,其中9例患者出现粒细胞缺乏。8例患者出现Ⅲ~Ⅳ级血小板减少。15例患者出现感染性发热,1例患者因疾病进展而死亡,其余9例经抗感染治疗后痊愈,5例患者有效控制。3例患者出现腹泻。7例患者出现便秘。2例患者出现间质性肺炎。2例患者注射部位出现红肿。结论阿扎胞苷用于治疗中高危老年MDS的疗效较好,安全性较高,临床可用于不能进行造血干细胞移植的患者。Objective To investigate the efficacy and safety of azacitidine in the treatment of middle-and-high-risk myelodysplastic syndrome(MDS) in the elderly.Methods A retrospective analysis was made to the clinical data of 21 elderly with middle-and-high-risk MDS hospitalized during the period from February,2017 to February,2019;azacitidine with a dose of 75 mg/m2·d was administrated to all the elderly and 1 course lasted for 28 days;the efficacy and safety of treatment were analyzed and evaluated.Results The average duration of the treatment was(5.05±1.89) days,the average interval between the courses was(25.77±5.23) days and the average follow-up was(137.27±73.45) days;18 cases went through 4 courses and over with an effective rate of 38.89%(7/18),including 3 cases in stable condition and 4 cases of progression(2 cases of relapse,2 cases converting to acute myeloid leukemia);neutropenia of varied degrees was found in all the cases,including 9 cases with ranulocytopenia;8 cases were of grade Ⅲ to Ⅳ thrombocytopenia;infectious fever was found in 15 cases,including 1 death due to disease progression,9 recovered and 5 under effective control after anti-infective therapy;diarrhea was found in3 cases;constipation was found in 7 cases;interstitial pneumonia was found in 2 cases;redness and irritation at injection spot was found in 2 cases.Conclusions Azacitidine is of better effect and high safety in the treatment of middle-and high-risk MDS in the elderly and can be a recommend for the cases unable to undergo hematopoietic stem cell transplantation.

关 键 词：老年 中高危骨髓增生异常综合征 阿扎胞苷 疗效 安全性 

分 类 号：R73[医药卫生—肿瘤]