含聚乙二醇化重组人粒细胞集落刺激因子预激方案治疗老年人初治急性髓系白血病的临床观察免费  

Clinical observation of priming regimen with pegylated recombinant human granulocyte colony-stimulating factor for treatment of initial treatment elderly patients with acute myeloid leukemia

作　　者：周茉[1] 邵钰[1] 单学赟[1] 王纯斌[1] 王品 孙乃同[1] Zhou Mo;Shao Yu;Shan Xueyun;Wang Chunbin;Wang Pin;Sun Naitong(Department of Hematology,Yancheng Third People's Hospital of Jiangsu Province,Yancheng 224000,China)

机构地区：[1]江苏省盐城市第三人民医院血液科,224000

出　　处：《白血病．淋巴瘤》2019年第12期739-742,共4页Journal of Leukemia & Lymphoma

摘　　要：目的观察聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)用于老年人初治急性髓系白血病(AML)预激方案的临床疗效与不良反应。方法回顾性分析2015年2月至2019年1月盐城市第三人民医院收治的接受预激方案化疗的35例老年初治AML(非M3型)患者,根据化疗方案中粒细胞集落刺激因子(G-CSF)的不同,将患者分为两组,其中PEG-rhG-CSF组15例,在化疗第0天单次使用PEG-rhG-CSF 6 mg,皮下注射;重组人粒细胞集落刺激因子(rhG-CSF)组20例,使用rhG-CSF每天200μg/m^2,皮下注射第0天至第13天,其间根据白细胞计数暂停或继续使用rhG-CSF。两组预激方案均应用阿糖胞苷联合阿柔比星或阿糖胞苷联合高三尖杉酯碱方案。比较两组患者的疗效与不良反应。结果PEG-rhG-CSF组完全缓解5例,部分缓解6例,未缓解4例,有效11例;rhG-CSF组完全缓解8例,部分缓解7例,未缓解5例,有效15例;两组总有效差异无统计学意义(χ^2=0.012,P=0.911)。不良反应方面,两组感染性发热、骨骼疼痛的发生率及粒细胞缺乏持续时间、血小板减少持续时间比较,差异均无统计学意义(均P>0.05)。结论在AML预激方案化疗中,PEG-rhG-CSF与rhG-CSF的临床疗效及主要不良反应无明显差异,但PEG-rhG-CSF可简化预激方案的操作,降低患者化疗期间疼痛及局部感染风险,提高治疗依从性。Objective To evaluate the efficacy and side effects of priming regimen with pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)in the treatment of initial treatment elderly patients with acute myeloid leukemia(AML).Methods Thirty-five elderly patients with early-stage AML(non-M3)who received pre-excitation chemotherapy in Yancheng Third People's Hospital from February 2015 to January 2019 were retrospectively analyzed.According to the different granulocyte colony-stimulating factor(G-CSF)in the chemotherapy regimen,15 cases were in PEG-rhG-CSF group,6 mg PEG-rhG-CSF was used alone on day 0 by subcutaneous injection;20 cases were in recombinant human granulocyte colony-stimulating factor(rhG-CSF)group,200μg/m^2 rhG-CSF was used per day from day 0 to day 13 by subcutaneous injection,rhG-CSF was suspended or continued according to the number of white blood cells.In addition,both groups were given priming regimen with cytarabine and arubicin,or cytarabine and harringtonine.The efficacy and adverse reactions of the two groups were compared.Results In the PEG-rhG-CSF group,there were 5 cases of complete remission,6 cases of partial remission,4 cases of non-remission,and 11 cases were effective.In the rhG-CSF group,there were 8 cases of complete remission,7 cases of partial remission,5 cases of non-remission,and 15 cases were effective.There was no significant difference in the efficacy between the two groups(χ^2=0.012,P=0.911).In terms of adverse reactions,the incidence of infectious fever,bone pain,duration of neutropenia,and duration of thrombocytopenia were not statistically significant(all P>0.05).Conclusions In the pre-excitation chemotherapy for AML,the clinical efficacy and adverse effects of PEG-rhG-CSF are similar to rhG-CSF.However,the use of PEG-rhG-CSF can simplify the operation and reduce the pain and risk of local infection during chemotherapy.

关 键 词：白血病 髓样 急性 聚乙烯二醇类 粒细胞集落刺激因子 预激方案 

分 类 号：R733.71[医药卫生—肿瘤]