成人急性髓系白血病巩固化疗后骨髓抑制情况及其安全性分析  

Analysis of Bone Marrow Suppression and Safety After Consolidation Chemotherapy in Adult Acute Myeloid Leukemia

作　　者：董光苹 郝杰 刘占云 胡琦[2] DONG Guang-ping;HAO Jie;LIU Zhan-yun;HU Qi(Department of Hematology,Shanghai Beizhan Hospital,Shanghai 200070,China;Department of Hematology,Shanghai Traditional Chinese Medicine Hospital,Shanghai 200071,China)

机构地区：[1]上海市北站医院血液科,上海200070 [2]上海市中医医院血液病科,上海200071

出　　处：《医学信息》2021年第17期129-131,共3页Journal of Medical Information

基　　金：上海市静安区卫生科研青年项目(编号:2019QN08)。

摘　　要：目的探讨成人急性髓系白血病巩固化疗后骨髓抑制情况及其安全性。方法回顾性分析2019年10月~2020年6月上海市北站医院收治的成人急性髓系白血病巩固化疗患者56例,根据治疗方案分为IA巩固治疗组26例,中剂量Ara-c巩固治疗组30例。IA巩固治疗组予盐酸伊达比星治疗,中剂量Ara-c巩固治疗组予阿糖胞苷治疗,比较两组化疗后外周血象(白细胞、血小板)变化、骨髓抑制情况及不良反应发生情况。结果d10~12中剂量Ara-c巩固治疗组外周血白细胞计数低于IA巩固治疗组,d18~20中剂量Ara-c巩固治疗组外周血白细胞计数高于IA巩固治疗组,差异有统计学意义(P<0.05);d13~17、d21~出院两组外周血白细胞比较,差异无统计学意义(P>0.05);d11~12中剂量Ara-c巩固治疗组外周血血小板计数低于IA巩固治疗组,d22~23中剂量Ara-c巩固治疗组外周血血小板计数高于IA巩固治疗组,差异有统计学意义(P<0.05);d13~21、d24~出院两组外周血血小板计数比较,差异无统计学意义(P>0.05);两组骨髓抑制程度比较,差异无统计学意义(P>0.05);两组感染、心肝肾功能损害、电解质紊乱发生率比较,差异无统计学意义(P>0.05)。结论成人急性髓系白血病巩固化疗中,两种方案骨髓抑制程度及安全性方面基本一致,但中剂量Ara-c巩固治疗对患者化疗后白细胞、血小板数量下降及回升的影响均小于IA巩固治疗。Objective To investigate the status and safety of bone marrow suppression after consolidation chemotherapy in adults with acute myeloid leukemia.Methods A retrospective analysis of 56 adult acute myeloid leukemia patients undergoing consolidation chemotherapy in Shanghai Beizhan Hospital from October 2019 to June 2020.According to the treatment plan,they were divided into 26 cases in the IA consolidation treatment group and 30 cases in the medium-dose Ara-c consolidation treatment group.The IA consolidation treatment group was treated with idarubicin hydrochloride,and the medium-dose Ara-c consolidation treatment group was treated with cytarabine.The changes in peripheral blood(white blood cells,platelets),bone marrow suppression and adverse reactions were compared between the two groups after chemotherapy.Results The peripheral blood white blood cell count of the middle-dose Ara-c consolidation treatment group was lower than that of the IA consolidation treatment group on d10-12.On d18-20,the middle-dose Ara-c consolidation treatment group had a higher peripheral blood white blood cell count than the IA consolidation treatment group,the differences were statistically significant(P<0.05);There was no statistically significant difference in peripheral blood leukocytes between the two groups on d13-17 and d21-discharge(P>0.05);On d11~12,the peripheral blood platelet count of the Ara-c consolidation treatment group was lower than that of the IA consolidation treatment group.On d22~23,the peripheral blood platelet count of the Ara-c consolidation treatment group was higher than that of the IA consolidation treatment group,the differences were statistically significant(P<0.05);There was no significant difference in peripheral blood platelet counts between the two groups on d13-21 and d24-discharge(P>0.05);There was no significant difference in the degree of bone marrow suppression between the two groups(P>0.05);There was no significant difference in the incidence of infection,heart,liver and kidney damage,and electrol

关 键 词：成人急性髓系白血病 骨髓抑制 白细胞 血小板 

分 类 号：R733.71[医药卫生—肿瘤]