环孢素结合CAG化疗对难治性急性髓细胞白血病的治疗效果及安全性分析  

Efficacy and Safety of Cyclosporine Combined with CAG Chemotherapy in Treatment of Refractory Acute Myeloid Leukemia

作　　者：张辉 严匡华 Zhang Hui;Yan Kuanghua(Department of Blood Specialty,The First Affiliated Hospital of Henan University,Kaifeng,Henan,475000,China)

机构地区：[1]河南大学第一附属医院血液科,河南开封475000

出　　处：《黑龙江医学》2024年第10期1174-1176,共3页Heilongjiang Medical Journal

基　　金：河南省开封市科技发展计划项目(1503057)。

摘　　要：目的:观察环孢素联合CAG化疗方案治疗难治性急性髓细胞白血病(AML)的效果及安全性,为临床提供参考。方法:选取2020年5月—2022年3月河南大学第一附属医院收治的123例难治性AML患者作为研究对象,采用抽签法将其分为联合组(62例)和化疗组(61例)。两组患者均统一接受CAG化疗[阿克拉霉素+阿糖胞苷+人重组粒细胞集落刺激因子(G-CFS)],联合组在此基础上联合环孢素配合化疗。治疗结束后对患者开展为期半年的随访,比较两组患者治疗后的近期、远期疗效及药物副反应发生情况。结果:治疗后,联合组的总有效率(88.71%)高于化疗组(73.77%),差异有统计学意义(χ^(2)=7.323,P<0.05);联合组的白细胞计数(WBC)、血小板输注量以及粒细胞缺乏持续时间均低于化疗组,血小板计数(PLT)高于化疗组,差异有统计学意义(χ^(2)=3.121、12.510、11.231、3.423,P<0.05)。随访期间,联合组的病情复发率及死亡率均高于化疗组,生存质量测定量表(QOL-BREF)评分高于化疗组,差异有统计学意义(χ^(2)=5.643、4.884;t=5.412,P<0.05);治疗后,联合组的药物副反应发生率(11.29%)略高于化疗组(9.84%),差异无统计学意义(χ^(2)=0.111,P>0.05)。结论:在予以难治性AML患者CAG化疗同时联合应用环孢素辅助治疗,可有效增强其近期、远期疗效,对促进患者症状改善、延长生存周期均有积极意义,联合应用此药未明显增强药物副反应发生风险,安全性较高。Objective:To observe the efficacy and safety of cyclosporine combined with CAG chemotherapy in the treatment of refractory AML.Methods:Taking 123 patients with refractory AML admitted to The First Affiliated Hospital of Henan University from May 2020 to March 2022 as the research objects.They were divided into combination group(62 cases)and chemotherapy group(61 cases)with drawing lots.Patients of two groups received CAG chemotherapy(ACLA+A-arc+G-CFS)uniformly.The combination group used cyclosporine with chemotherapy.After the treatment,the patients were followed up for half a year.The short-term and long-term efficacy and adverse drug reactions of the two groups were compared.Results:After treatment,the total effective rate in the combined group was 88.71%,which was higher than that 73.77%of chemotherapy group,with statistically significant difference(χ^(2)=7.323,P<0.05).WBC,platelet transfusion and the duration of agranulocytosis were lower than those in the chemotherapy group,with statistically significant difference(χ^(2)=3.121,12.510,11.231,3.423;P<0.05).During the follow-up period,the relapse rate and mortality rate of the combined group were higher than those of the chemotherapy group,and the QOLBREF score was higher than that of the chemotherapy group,with statistically significant difference(χ^(2)=5.643,4.884;t=5.412;P<0.05).The incidence of side effects after treatment in the combination group was 11.29%,which was slightly higher than that in the chemotherapy group(9.84%),with no statistically significant difference(χ^(2)=0.111,P>0.05).Conclusion:The combination of CAG chemotherapy and cyclosporine adjuvant therapy for refractory AML patients can effectively enhance the short and long term efficacy,promote the improvement of symptoms and prolong the life cycle of patients.The combined use of this drug does not significantly enhance the risk of side effects,and has high safety.

关 键 词：急性髓细胞白血病 CAG化疗 环孢素A 疾病缓解 用药安全性 

分 类 号：R466.11[医药卫生—临床医学]