地西他滨与CHAG方案治疗AML1/ETO阳性复发难治急性髓系白血病的临床效果  

Clinical Efficacy of Decitabine and CHAG Regimen in the Treatment of AML1/ETO-Positive Relapsed and Refractory Acute Myeloid Leukemia

作　　者：张彭辉[1] 李佳佳[1] 边静[1] ZHANG Penghui;LI Jiajia;BIAN Jing(Department of Pharmaceutical Dispensing,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院药品调剂科,河南洛阳471003

出　　处：《河南医学研究》2023年第6期1098-1102,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190547)。

摘　　要：目的分析地西他滨与阿糖胞苷+高三尖杉酯碱+阿克拉霉素+重组人粒细胞集落刺激因子(CHAG)方案治疗急性髓系白血病1/ETO融合基因(AML1/ETO)阳性复发难治急性髓系白血病(AML)的临床效果。方法选取2015年7月至2020年7月河南科技大学第一附属医院收治的AML1/ETO阳性复发难治AML患者80例,按随机数字表法分为两组,对照组(39例)接受CHAG方案,研究组(41例)在对照组基础上接受地西他滨治疗。评价两组疗效,对比两组血象指标、血清碱性成纤维细胞生长因子(bFGF)水平、血清血管内皮生长因子(VEGF)水平、不良反应、生存情况。结果研究组有效率(73.17%)高于对照组(51.28%)(P<0.05)。治疗后两组白细胞计数(WBC)、血红蛋白(HGB)、血小板计数(PLT)均高于治疗前(P<0.05),且研究组WBC、HGB、PLT均高于对照组(P<0.05)。治疗后两组血清bFGF、VEGF水平均低于治疗前(P<0.05),且研究组血清bFGF、VEGF水平均低于对照组(P<0.05)。两组各不良反应发生情况比较,差异无统计学意义(P>0.05)。截至2021年7月,对照组随访期内共16例患者死亡,6个月生存率79.49%、1 a生存率58.97%;研究组随访期内共7例患者死亡,6个月生存率85.37%、1 a生存率82.93%。log-rank检验结果提示,两组生存情况有统计学意义(P<0.05)。结论地西他滨与CHAG方案能有效提高AML1/ETO阳性复发难治AML患者的临床效果,改善血象,调节血清bFGF、VEGF水平,延长生存时间,且未增加不良反应发生。Objective To analyze the clinical efficacy of decitabine and cytarabine+homoharringtonine+aclacinomycin+recombinant human granulocyte-colony stimulating factor(CHAG)regimen in the treatment of acute myeloid leukemia 1/eight twenty-one(AML1/ETO)-positive relapsed and refractory acute myeloid leukemia(AML).Methods From July 2015 to July 2020,80 AML1/ETO-positive relapsed and refractory AML patients were admitted to the First Affiliated Hospital of Henan University of Science and Technology.They were divided into two groups according to the random number table.The control group(39 cases)was given CHAG regimen,and the study group(41cases)was given decitabine treatment on the basis of the control group.The curative effect of the two groups was evaluated,the hemogram indicators,serum basic fibroblast growth factor(bFGF)level,serum vascular endothelial growth factor(VEGF)level,adverse reactions and follow-up status were compared between the two groups.Results The effective rate of the study group(73.17%)was higher than that of the control group(51.28%)(P<0.05).After treatment,the white blood cell count(WBC),hemoglobin(HGB)and platelet count(PLT)of the two groups were higher than those before treatment(P<0.05),and the WBC,HGB and PLT of the study group were higher than those of the control group(P<0.05).After treatment,the serum bFGF and VEGF levels in the two groups were lower than before treatment(P<0.05),and the serum bFGF and VEGF levels in the study group were lower than those in the control group(P<0.05).There were no differences in the occurrence of adverse reactions between the two groups(P>0.05).As of July 2021,a total of 16 patients in the control group had died during the follow-up period,the 6-month survival rate was 79.49%and the 1-year survival rate was 58.97%.A total of 7 patients in the study group had died during the follow-up period,the 6-month survival rate was 85.37%and the 1-year survival rate was 82.93%.Log-rank test results suggested that there was difference in the survival between the two groups(

关 键 词：地西他滨 CHAG方案 AML1/ETO阳性 复发难治急性髓系白血病 疗效 

分 类 号：R557[医药卫生—血液循环系统疾病]