维奈克拉联合阿扎胞苷治疗老年急性髓系白血病的疗效及其对患者免疫功能的影响  

The efficacy of venetoclax combined with azacitidine in the treatment of elderly patients with acute myeloid leukemia and its effect on immune function

作　　者：符丽梅[1] 廖欣[1] 熊暮珺 Fu Limei;Liao Xin;Xiong Mujun(Department of Hematology,First People's Hospital of Chenzhou City,Chenzhou,Hunan f 423000,P.R.China)

机构地区：[1]郴州市第一人民医院血液内科,湖南郴州423000

出　　处：《老年医学与保健》2022年第1期125-128,134,共5页Geriatrics & Health Care

基　　金：郴州市技术创新引导项目(lcyl2021051)。

摘　　要：目的观察维奈克拉联合阿扎胞苷治疗老年急性髓系白血病(AML)的疗效及其对患者免疫功能的影响,为维奈克拉治疗老年AML提供依据。方法选取2021年1月—2021年12月在郴州市第一人民医院收治的60例老年AML患者,采用数字表法随机分为观察组(n=30)和对照组(n=30)。对照组给予阿扎胞苷治疗,观察组在与对照组相同治疗的基础上加服维奈克拉片治疗,每个疗程28d,2组均治疗2个疗程。观察并比较2组治疗总缓解率、治疗不良反应、血液学与免疫功能指标变化。结果观察组治疗总缓解率显著高于对照组(P<0.05)。2组治疗不良反应总发生率差异无统计学意义(P> 0.05)。治疗前,2组血液学与免疫功能指标值差异均无统计学意义(P> 0.05);治疗后,观察组血红蛋白、血小板计数和白细胞计数均显著高于对照组(P<0.05),而骨髓原始细胞比例、CD3+、CD4+、CD8+和CD4+/CD8+比率均显著低于对照组(P<0.05)。结论维奈克拉联合阿扎胞苷可有效治疗老年AML,能提高治疗总缓解率,其可能通过T细胞途径改善患者的免疫功能,具有一定的临床应用价值。Objective To observe the efficacy of venetoclax combined with azacitidine in the treatment of elderly patients with acute myeloid leukemia(AML)and its effect on immune function of patients,and provide evidence for the treatment of elderly patients with AML with venetoclax. Methods 60 elderly patients with AML treated in First People’s Hospital of Chenzhou City from January2021 to December2021 were selected and randomly divided into control group and observation group by digital table method,with30 cases in each group. The control group was treated with azacitidine,and the observation group was treated with venetoclax on the basis of the same treatment in the control group. Each course of treatment was28 days,and the two groups were treated for2 courses. The total remission rate,adverse reactions,indexes of hematology and immune function were observed and compared between the two groups. Results The total remission rate in the observation group was significantly higher than that in the control group(P< 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P> 0.05). There were no statistically significant differences in the levels of the indexes of hematology and immune function between the two groups before treatment(P> 0.05).After treatment,the levels of hemoglobin,platelet count and WBC count in the observation group were significantly higher than those in the control group(P< 0.05),while the proportion of bone marrow primordial cells,CD3+,CD4+,CD8+and CD4+/CD8+ ratio were significantly lower than those in the control group(P< 0.05). Conclusion Venetoclax combined with azacitidine can effectively treat AML in elderly patients,and improve the total remission rate of treatment. It may improve the immune function of patients through the T cell pathway,and has certain clinical application value.

关 键 词：老年 急性髓系白血病 维奈克拉 阿扎胞苷 疗效 安全性 

分 类 号：R733.71[医药卫生—肿瘤]