青黄散联合低强度化疗对老年急性髓系白血病患者生存期及预后因素的分析  

Survival Time and Prognostic Factors of Elderly Patients with Acute Myeloid Leukemia Treated with Qinghuang Powder and Low-intensity Chemotherapy

作　　者：吴雨荷 肖海燕[1] 全日城[1] 唐旭东[1] 刘为易 吕妍[1] 刘驰[1] 李柳[1] 胡晓梅[1] WU Yu-he;XIAO Hai-yan;QUAN Ri-cheng;TANG Xu-dong;LIU Wei-yi;LYU Yan;LIU Chi;LI Liu;HU Xiao-mei(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091;Graduate School,China Academy of Chinese Medical Sciences,Beijing 100700)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]中国中医科学院研究生院,北京100700

出　　处：《世界中西医结合杂志》2022年第8期1609-1614,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：中央级公益性科研院所基本科研业务费专项(ZZ10-016)。

摘　　要：目的探讨青黄散为主与低强度化疗治疗老年急性髓系白血病(Acute Myeloid Leukemia,AML)患者的临床疗效及预后影响因素。方法回顾性分析2015年1月—2020年12月期间于中国中医科学院西苑医院接受治疗的80例老年AML患者的临床资料,分为青黄散组35例和低强度化疗组45例,比较两组患者的中位生存期、年生存率以及不良反应发生率,并分析预后影响因素。结果80例患者的中位生存期为11个月,1年、2年和3年生存率分别为45.51%、17.96%和11.05%。影响中位生存期的单因素分析显示,遗传学、体能状况评分(PS评分)以及并发症指数评分(HCT-CI评分)是影响预后的主要因素,差异有统计学意义(P<0.05);多因素分析显示,PS评分是影响预后的独立因素(P<0.05)。青黄散组与低强度化疗组比较,中位生存期(12个月vs 10个月,χ^(2)=0.061,P=0.806)、1年生存率(48.6%vs 40.0%,χ^(2)=0.588,P=0.443)、2年生存率(11.4%vs 20.0%,χ^(2)=1.063,P=0.303)和3年生存率(5.7%vs 13.3%,χ^(2)=0.564,P=0.453)差异无统计学意义(P>0.05)。两组患者中位生存期影响因素分析显示,青黄散组与低强度化疗组继发性AML(11个月vs 8个月,χ^(2)=1.097,P=0.295)、遗传预后不良(9个月vs 7个月,χ^(2)=0.037,P=0.847)、PS评分≥3分(10个月vs 7个月,χ^(2)=1.035,P=0.309)、HCT-CI评分≥4分(11个月vs 7个月,χ^(2)=0.455,P=0.500)患者中位生存期比较,差异均无统计学意义(P>0.05)。两组患者不良反应发生率比较,青黄散组骨髓抑制发生率明显低于低强度化疗组,差异有统计学意义(P<0.05)。结论遗传学、PS评分以及HCT-CI评分是影响老年AML患者的预后因素。青黄散为主与低强度化疗方案治疗老年AML生存期相当,但青黄散为主方案骨髓抑制发生率较低,该方案可作为不耐受低强度化疗老年AML患者的替代方案。Objective To investigate the clinical efficacy and prognostic factors of Qinghuang Powder and low-intensity chemotherapy in the treatment of elderly patients with acute myeloid leukemia(AML).Methods The clinical data of 80 elderly patients with AML treated in Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2015 to December 2020 were retrospectively analyzed.The patients were assigned into a Qinghuang Powder group(n=35)and a low-intensity chemotherapy group(n=45).The median survival time,annual survival rate,and incidence of adverse reactions were compared between the two groups,and the influencing factors of prognosis were analyzed.Results The median survival time of the 80 patients was 11 months,and the 1-,2-,and 3-year survival rates were 45.51%,17.96%,and 11.05%,respectively.The univariate analysis showed that genetics,performance status(PS)score,and hematopoietic cell transplantation comorbidity index(HCT-CI)score were the main prognostic factors(P<0.05).The multivariate analysis showed that PS score was the independent prognostic factor(P<0.05).The median survival(12 months vs.10 months,χ^(2)=0.061,P=0.806),1-year survival(48.6%vs.40.0%,χ^(2)=0.588,P=0.443),2-year survival(11.4%vs.20.0%,χ^(2)=1.063,P=0.303),and 3-year survival(5.7%vs.13.3%,χ^(2)=0.564,P=0.453)showed no significant differences between Qinghuang Powder group and low-intensity chemotherapy group.The median survival time of patients with secondary AML(11 months vs.8 months,χ^(2)=1.097,P=0.295),poor genetic prognosis(9 months vs.7 months,χ^(2)=0.037,P=0.847),PS score≥3(10 months vs.7 months,χ^(2)=1.035,P=0.309),and HCT-CI score≥4(11 months vs.7 months,χ^(2)=0.455,P=0.500)showed no significant differences between Qinghuang Powder group and low-intensity chemotherapy group(P>0.05).The incidence of bone myelosuppression in Qinghuang Powder group was lower than that in low-intensity chemotherapy group(P<0.05).Conclusion Genetics,PS score,and HCT-CI score are prognostic factors in elderly patients with AML.The sur

关 键 词：急性髓系白血病 老年 青黄散 低强度化疗 

分 类 号：R733.7[医药卫生—肿瘤]