Ven+AZA方案和CAG+AZA方案治疗老年复发难治性急性髓系白血病患者的效果比较  

Effect Comparision of Ven+AZA Regimen and CAG+AZA Regimen in the Treatment of Elderly Patients with Recurrent and Refractory Acute Myeloid Leukemia

作　　者：丁辉[1] 陈芳 DING Hui;CHEN Fang(Department of Hematology,Huaihe Hospital of Henan University,Kaifeng 475000,China;Department of Nephrology,Huaihe Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学淮河医院血液内科,河南开封475000 [2]河南大学淮河医院肾内科,河南开封475000

出　　处：《河南医学研究》2025年第3期496-499,共4页Henan Medical Research

摘　　要：目的 比较维奈托克(Ven)+阿扎胞苷(AZA)方案和CAG+AZA方案治疗老年复发难治性急性髓系白血病(AML)患者的效果和不良反应。方法 选取2019年6月至2022年6月在河南大学淮河医院血液内科接受治疗的112例老年复发难治性AML患者,采用抽签分组将患者分为Ven组(56例)和CAG组(56例),Ven组患者以Ven+AZA方案治疗,CAG组患者以CAG+AZA方案治疗,均持续治疗12周。比较两组患者治疗前后的血管内皮生长因子(VEGF)表达水平、血清中转化生长因子β1(TGF-β1),肿瘤坏死因子-α(TNF-α)水平、白介素-17(IL-17)水平,以及肝肾异常、肌肉关节疼痛、肠胃不适、外周水肿、皮疹等不良反应发生情况。结果 Ven组患者的未缓解率为28.57%,低于CAG组患者的48.21%,差异有统计学意义(P<0.05)。治疗12周后,Ven组AML患者的血清VEGF、TGF-β1水平均低于CAG组,差异有统计学意义(P<0.05)。治疗12周后,Ven组患者的血清TNF-α、IL-17水平均高于CAG组,差异有统计学意义(P<0.05)。Ven组和CAG组患者肝肾异常、肌肉关节疼痛、肠胃不适、外周水肿、皮疹等不良反应发生率分别为46.43%和55.36%,差异无统计学意义(P>0.05)。结论 Ven+AZA方案治疗老年复发难治性AML患者的疗效优于CAG+AZA方案,但两种治疗方案产生的不良反应无明显差异。Objective To compare the effect and adverse reactions of venetoclax(Ven)+azacitidine(AZA)regimen and CAG+AZA regimen in the treatment of elderly patients with recurrent and refractory acute myeloid leukemia(AML).Methods A total of 112 elderly patients with recurrent and refractory AML treated in Department of Hematology Huaihe Hospital of Henan University were enrolled from June 2019 to June 2022.According to envelope method,they were divided into Ven group(56 cases,Ven+AZA regimen)and CAG group(56 cases,CAG+AZA regimen).All patients were treated for 12 weeks.The levels of vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α)and interleukin-17(IL-17)and the occurrence of adverse reactions(liver-kidney abnormalities,muscle joint pain,gastrointestinal discomfort,peripheral edema,rash)were compared between the two groups before and after treatment.Results The non-remission rate in Ven group was lower than that in CAG group(28.57%vs 48.21%,P<0.05).After 12 weeks of treatment,levels of serum VEGF and TGF-β1 in Ven group were lower than those in CAG group(P<0.05),while levels of serum TNF-αand IL-17 were higher than those in CAG group(P<0.05).There was no significant difference in the incidence of adverse reactions between Ven group and CAG group(46.43%vs 55.36%,P>0.05).Conclusion The curative effect of Ven+AZA regimen is superior to CAG+AZA regimen in elderly patients with recurrent and refractory AML.However,there is no significant difference in adverse reactions between the two methods.

关 键 词：急性髓系白血病 维奈托克 阿扎胞苷 CAG方案 

分 类 号：R733.71[医药卫生—肿瘤]