地西他滨联合减剂量MAG方案治疗老年急性髓系白血病的疗效及安全性  

Efficacy and safety of decitabine combined with reduced-dose MAG regimen in elderly patients with acute myeloid leukemia

作　　者：温静 刘锋[1] 史瑞 雷小茹 郭晓波[1] 宋艳萍[1] WEN Jing;LIU Feng;SHI Rui;LEI Xiaoru;GUO Xiaobo;SONG Yanping(Xi'an Central Hospital,Xi'an Institute of Hematology,Shaanxi Xi'an 710002,China)

机构地区：[1]西安市中心医院西安市血液病研究所,陕西西安710002

出　　处：《现代肿瘤医学》2022年第23期4290-4293,共4页Journal of Modern Oncology

基　　金：陕西省西安市科学技术基金(编号:20180509YX35F29)。

摘　　要：目的:评价地西他滨联合减剂量MAG方案[米托蒽醌(MTN)+阿糖胞苷(Ara-C)+粒细胞集落刺激因子(G-CSF)]治疗老年急性髓系白血病(acute myeloid leukemia,AML)患者的疗效及安全性。方法:本研究回顾性分析2016年06月至2020年12月收治的50例初诊老年急性髓系白血病患者,使用地西他滨联合MAG方案进行2个周期化疗,评估其疗效及安全性。结果:50例患者均完成2个周期化疗,骨髓造血恢复后进行评估。其中完全缓解(complete response,CR)29例(58.00%),部分缓解(partial response,PR)14例(28.00%),总缓解率(overall response rate,ORR)为86.00%(43/50)。所有患者均出现Ⅲ-Ⅳ级血液学毒性,其中24例(48.00%)患者粒细胞缺乏期出现感染,16例(32.00%)出现Ⅱ度出血。31例(62.00%)出现Ⅰ-Ⅱ级恶心、呕吐、脏器损害等非血液学毒性,但均可耐受,无治疗相关死亡病例。性别、年龄、KPS评分对完全缓解率无明确影响(P>0.05)。细胞遗传学良好者较细胞遗传学不良者缓解率高,差异具有统计学意义(P<0.05)。结论:地西他滨联合减剂量MAG方案治疗老年急性髓系白血病疗效确切,缓解率高,毒副反应可耐受,适用于临床广泛应用。Objective:To observe the efficacy and safety of decitabine combined with reduced MAG(MTN+Ara-C+G-CSF)in the treatment of elderly acute myeloid leukemia(AML).Methods:The clinical data of 50 patients,who were induced by decitabine combined with MAG regimen,with newly diagnosed elderly AML admitted to our institute from June 2016 to December 2020 were retrospectively analysed.The efficacy and its safety were observed.Results:All 50 patients completed 2 courses of chemotherapy,and the bone marrow test were evaluated after the recovery of hematopoiesis.Among them,the complete remission(CR)rate was 58.00%,and the partial remission(PR)rate was 28.00%,thus overall remission rate(ORR)was 86.00%.All patients had experiencedⅢ-Ⅳgrade hematologic toxicity.48.00%patients underwent infection during febrile neutropenic after chemotherapy,and 32.00%patients encountered gradeⅡbleeding.62.00%patients suffered toleranced non-hematologic toxicity,such as nausea,vomiting and organ damage.There were no treatment related deaths.Gender,age,KPS had no significant effect on CR(P>0.05).Patients with poor cytogenetics had low CR compared with other cytogentics patients(P<0.05).Conclusion:Decitabine combined with reduced MAG regimen was effective in treatment of elderly AML patients.The remission rate was high and the adverse effect could be tolerated.

关 键 词：地西他滨 米托蒽醌 老年急性髓系白血病 疗效 不良反应 

分 类 号：R733[医药卫生—肿瘤]