低剂量地西他滨联合减量HAG方案治疗老年低增生急性髓系白血病疗效观察  

Therapeutic effect of low-dose decitabine combined with reduced HAG regimen in the treatment of elderly patients with hypoproliferative acute myeloid leukemia

作　　者：刘锋[1] 杜明珠[1] 李光[1] 高飞[1] 戴进前[1] 郭晓波[1] 宋艳萍[1] Liu Feng;Du Mingzhu;Li Guang;Gao Fei;Dai Jinqian;Guo Xiaobo;Song Yanping(Institute of Hematology of Xi'an,Xi'an Central Hospital,Shaanxi Xi'an 710004,China.)

机构地区：[1]西安市中心医院西安市血液病研究所

出　　处：《现代肿瘤医学》2020年第4期626-629,共4页Journal of Modern Oncology

基　　金：陕西省自然科学基础研究项目(编号:2013JM4016,2018SF-205)

摘　　要：目的:观察低剂量地西他滨联合减量HAG方案(HHT、Ara-C、G-CSF)诱导治疗老年低增生急性髓系白血病的疗效及安全性。方法:对我院2015年1月至2018年1月收治的46例初诊的老年低增生急性髓系白血病患者进行回顾性分析,应用低剂量地西他滨联合减量HAG方案诱导化疗,观察疗效并评价其安全性。结果:46例患者均完成2个疗程治疗,骨髓造血恢复后复查骨髓象评估疗效。其中完全缓解(complete remission,CR)20例(43.5%),部分缓解(partial remission,PR)9例(19.6%),总有效率(overall remission rate,ORR)为63.0%(29/46)。46例患者均出现Ⅲ-Ⅳ级血液学毒性、粒细胞减少引起的感染及血小板减少引起的出血为主的合并症。恶心呕吐、肝肾功损害、心脏毒性等非血液学毒性均可耐受,均无治疗相关死亡病例。性别、年龄、KPS评分对完全缓解率无明确影响(P>0.05)。正常细胞遗传学患者较不良细胞遗传学患者缓解率高,具有统计学差异(P<0.05)。结论:低剂量地西他滨联合减剂量HAG方案治疗老年低增生急性髓系白血病疗效确切,缓解率较高,毒副反应可安全耐受。To observe the efficacy and safety of low-dose decitabine combined with reduced HAG regimen(HHT,Ara-C,G-CSF)in the treatment of elderly patients with proliferative acute myeloid leukemia.Methods:A retrospective analysis of 46 patients with newly diagnosed hypoproliferative acute myeloid leukemia admitted to our hospital from January 2015 to January 2018 were induced by low-dose decitabine combined with reduced HAG regimen,to observe the efficacy and evaluate its safety.Results:All 46 patients completed 2 courses of chemotherapy,and the bone marrow was evaluated after the recovery of hematopoiesis.Among them,complete remission(CR)was performed in 20 cases(43.5%).Partial remission(PR)was 19.6%(9 cases),and total remission rate(ORR)was 63.0%(29/46).All patients developed gradeⅢ-Ⅳhematologic toxicity.The main complications were infection caused by neutropenia and bleeding caused by thrombocytopenia.Non-hematologic toxicity such as nausea and vomiting,liver and kidney damage,and cardiotoxicity can be tolerated without treatment-related death.Gender,age,and KPS scores had no significant effect on complete remission rate(P>0.05).Patients with normal cytogenetics had higher remission rate than those with poor cytogenetics,and the difference was statistically significant(P<0.05).Conclusion:Low-dose decitabine combined with reduced-dose HAG regimen is effective in the treatment of elderly patients with hypoproliferative acute myeloid leukemia.The remission rate is high and the adverse reactions can be tolerated.

关 键 词：地西他滨 高三尖杉酯碱 阿糖胞苷 老年患者 低增生急性髓系白血病 疗效 

分 类 号：R733.71[医药卫生—肿瘤]