去甲基化药物治疗骨髓增生异常综合征1个疗程后血小板数倍增对治疗反应及疗效的预测价值  

Platelet Count Doubling after One Course of Demethylated Drug Therapeutic Predicts the Treatment Response and Efficacy of Patients with Myelodysplastic Syndrome

作　　者：惠卉 余浩源 李德鹏 HUI Hui;YU Hao-Yuan;LI De-Peng(Deparment of Hematology,The Afiliated Hospital of Xuzhou Medical Universiy,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院血液科,江苏徐州221000

出　　处：《中国实验血液学杂志》2024年第1期184-189,共6页Journal of Experimental Hematology

摘　　要：目的:探讨去甲基化药物(HMA)治疗1个疗程后血小板数倍增(血小板计数加倍)对骨髓增生异常综合征(MDS)治疗反应及疗效的预测价值。方法:收集2017年1月1日至2022年3月31日就诊于徐州医科大学附属医院接受单用去甲基化药物治疗的75例MDS患者临床及随访资料。根据MDS患者治疗1个疗程后血小板数是否加倍分为血小板倍增组和血小板非倍增组,并进行组间数据统计分析,比较两组间治疗反应及疗效。此外,还比较了患者血小板的变化在阿扎胞苷和地西他滨治疗中的差异。结果:血小板倍增组在治疗3个疗程后ORR明显优于非倍增组(P=0.002),两组获血液学改善的病例数差异有显著统计学意义(P=0.005)。此外,血小板倍增组和非倍增组患者的中位生存期(MST)分别为26和11个月(P=0.001)。血小板倍增组的总生存期(OS)、1及2年OS率也明显优于血小板非倍增组。多变量COX回归分析结果显示,在治疗1个疗程后血小板数倍增是MDS患者OS的独立预测因子(P=0.013)。阿扎胞苷治疗MDS患者血小板数倍增的反应率与地西他滨相比差异无统计学意义(33.3%vs 23.8%,P>0.05)。结论:治疗1个疗程后血小板数倍增可作为MDS患者去甲基化药物治疗反应率和较长OS的预测指标。此外,用阿扎胞苷和地西他滨治疗MDS患者血小板数倍增的反应率无明显差异。Objective:To investigate the predictive value of platelet doubling(platelet count doubling)after one course of hypomethylating agents(HMA)on the treatment response and efficacy of myelodysplastic syndrome(MDS).Methods:Clinical and pathological data of 75 patients who received HMA in our hospital from January 2017 to March 2022 were collected and analyzed.All patients were divided into two groups according to whether their platelet count doubled after one course of treatment,including platelet doubling group and non-doubling group,and statistical analysis was performed to compare the treatment response and efficacy between the two groups.In addition,platelet count changes were compared between azacitidine and decitabine therapy.Results:Compared with the non-doubling platelet count group,the ORR of the doubling platelet group was significantly better after 3 courses of treatment(P=0.002),and there was a statistically significant difference in the number of HI between the two groups(P=0.005).In addition,the median survival time(MST)was 26 months in the platelet doubling group and 11 months in the non-doubling group(P=0.001).The overall survival(OS)and 1-and 2-year survival rates of the platelet doubling group were also significantly better than those of the non-doubing group.Multivariate COX analysis showed that platelet count doubling was an independent predictor of OS in MDS patients after 1 course of treatment(P=0.013).There was no significant difference in the response rate of platelet count doubling between MDS patients treated with azacitidine and decitabine(33.3%vs 23.8%,P>0.05).Conclusion:Platelet count doubling after one course of treatment can be used as a predictor of response rate and survival of demethylated drug therapy in MDS patients.In addition,there was no significant difference in the response rate of platelets in MDS patients treated with azacitidine or dicetabine.

关 键 词：血小板 去甲基化药物 骨髓增生异常综合征 疗效 

分 类 号：R551.3[医药卫生—血液循环系统疾病]