低剂量阿扎胞苷联合减量HAG方案治疗老年低增生急性髓系白血病的疗效观察  

Therapeutic effect of low-dose azacitidine combined with reduced HAG regimen in the treatment of elderly patients with hypoproliferative acute myeloid leukemia

作　　者：李姜惠子 吴雯 杜明珠[1] 李光[1] 戴进前[1] 宋艳萍[1] 刘锋[1] LI Jianghuizi;WU Wen;DU Mingzhu;LI Guang;DAI Jinqian;SONG Yanping;LIU Feng(Institute of Hematology of Xi'an,Xi'an Central Hospital,Shaanxi Xi'an 710004,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710004

出　　处：《现代肿瘤医学》2024年第18期3532-3536,共5页Journal of Modern Oncology

基　　金：陕西省西安市科技计划项目[编号:201805095YX3SF29(3)]。

摘　　要：目的:评价低剂量阿扎胞苷联合减量HAG方案(HHT、Ara-C、G-CSF)诱导治疗新诊断老年低增生急性髓系白血病患者的疗效及安全性。方法:将我院2019年01月至2023年01月收治的56例初诊的老年低增生急性髓系白血病患者的治疗进行回顾性分析,采用低剂量阿扎胞苷联合减量HAG方案诱导化疗,观察治疗效果并评价其安全性。结果:56例患者均完成2个疗程化疗,外周血象恢复后复查骨髓形态评估其疗效。其中达到完全缓解(complete remission,CR)的患者25例(44.6%),部分缓解(partial remission,PR)的患者11例(19.6%),未缓解(no remission,NR)的患者20例(35.7%),总有效率(overall remission rate,ORR)为64.3%(36/56)。56例患者均出现Ⅲ-Ⅳ级血液学毒性,中性粒细胞减少导致的感染及血小板减少引起的出血为主要并发症。恶心、呕吐、食纳减退、肝肾功能损害、心脏毒性等非血液学毒性均可耐受,未发生治疗相关死亡病例。性别、年龄、KPS评分对完全缓解率无明显影响(P>0.05)。不良细胞遗传学患者较正常细胞遗传学患者缓解率低,具有统计学差异(P<0.05)。结论:低剂量阿扎胞苷联合减剂量HAG方案治疗新诊断老年低增生急性髓系白血病患者疗效确切,缓解率较高,毒副作用可安全耐受。Objective:To evaluate the efficacy and safety of low-dose azacitidine combined with reduced HAG regimen(HHT,Ara-C,G-CSF)in the treatment of newly diagnosed elderly patients with hypoproliferative acute myeloid leukemia.Methods:A retrospective analysis of 56 patients with newly diagnosed hypoproliferative acute myeloid leukemia admitted to our hospital from January 2019 to January 2023 were induced by low-dose azacitidine combined with reduced HAG regimen,to observe the efficacy and evaluate its safety.Results:All 56 patients completed 2 courses of chemotherapy,and their therapeutic effects were evaluated by reexamining bone marrow morphology after peripheral blood count recovery.Among them,25 patients(44.6%)achieved complete remission(CR),11 patients(19.6%)achieved partial remission(PR),and 20 patients(35.7%)achieved no remission(NR),the overall effective rate(ORR)was 64.3%(36/56).56 patients all experienced grade III-IV hematological toxicity,with infection caused by neutropenia and bleeding caused by thrombocytopenia as the main complications.Non hematological toxicity such as nausea,vomiting,decreased appetite,liver and kidney function damage,and cardiac toxicity can be tolerated,and no treatment-related deaths have occurred.Gender,age,and KPS score had no significant impact on the complete response rate(P>0.05).Patients with poor cytogenetics have a lower remission rate than those with normal cytogenetics,with statistical differences(P<0.05).Conclusion:Low-dose azacitidine combined with reduced-dose HAG regimen is effective in the treatment of elderly patients with hypoproliferative acute myeloid leukemia.The remission rate is relatively high and the adverse reactions can be tolerated.

关 键 词：阿扎胞苷 高三尖杉酯碱 阿糖胞苷 老年患者 低增生急性髓系白血病 疗效 

分 类 号：R733.71[医药卫生—肿瘤]