地西他滨治疗成人急性髓系白血病临床效果及对肿瘤相关巨噬细胞、免疫功能的影响  

Clinical Efficacy of Decitabine in Treatment of Adult with Acute Myeloid Leukemia and Its Effects on Tumor-associated Macrophages and Immune Function

作　　者：苑晓磊 胡东博 张国福[3] 张小可 YUAN Xiao-lei;HU Dong-bo;ZHANG Guo-fu;ZHANG Xiao-ke(Department of Oncology and Hematology,Liaoyang Central Hospital,Liaoyang,Liaoning 111000,China;Department of Clinical Laboratory,People's Hospital of Hongze District,Huai'an,Jiangsu 223100,China;Department of Clinical Laboratory,Infectious Disease Hospital of Jiamusi City,Jiamusi,Heilongjiang 154000,China)

机构地区：[1]辽阳市中心医院肿瘤血液科,辽宁辽阳111000 [2]淮安洪泽区人民医院检验科,江苏淮安223100 [3]佳木斯市传染病医院检验科,黑龙江佳木斯154000

出　　处：《解放军医药杂志》2022年第2期28-31,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：辽阳市科学技术局科技计划项目(辽市科发[2019]16号)。

摘　　要：目的探讨地西他滨(DAC)治疗成人急性髓系白血病临床效果及对肿瘤相关巨噬细胞、免疫功能的影响。方法回顾性分析2018年4月—2021年1月收治的成人急性髓系白血病122例的临床资料,根据治疗方法分为观察组65例和对照组57例。观察组给予DAC联合CAG方案治疗,对照组给予CAG方案治疗。比较2组临床疗效、肿瘤相关巨噬细胞、免疫指标水平及不良反应发生情况。结果观察组总有效率高于对照组(P<0.05)。2组治疗后巨噬细胞炎症蛋白-1α、CD206+、CD3+、CD4+、CD8+、CD4+/CD8+水平低于治疗前,且观察组低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论DAC联合CAG方案治疗成人急性髓系白血病可显著提高疗效,降低巨噬细胞及免疫指标水平,安全性较高。Objective To observe clinical efficacy of Decitabine in treatment of adult with acute myeloid leukemia(AML)and its effects on tumor-associated macrophages and immune function.Methods Clinical data of 122 adult patients with AML admitted between April 2018 and January 2021 was retrospectively analyzed.According to therapeutic methods,the patients were divided into observation group(n=65)and control group(n=57).Observation group was treated with DAC combined with CAG scheme,while control group was treated with CAG scheme.Clinical efficacy,tumor-associated macrophages,levels of immune indexes and incidence rate of adverse reactions were compared between two groups.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,levels of macrophage inflammatory protein-1α,CD206+,CD3+,CD4+,CD8+and CD4+/CD8+were significantly lower than those before treatment in two groups,and the levels in observation group were significantly lower than those in control group(P<0.05,P<0.01).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).Conclusion DAC combined with CAG regimen in treatment of adult patients with AML may significantly improve clinical efficacy and reduce levels of macrophages and immune indexes with good safety.

关 键 词：白血病 髓样 急性 地西他滨 阿糖胞苷 阿柔比星 粒细胞集落刺激因子 巨噬细胞炎症蛋白-1Α CD4-CD8比值 

分 类 号：R733.72[医药卫生—肿瘤]