地西他滨联合CHG方案治疗老年急性髓系白血病的疗效及安全性分析

Efficacy and safety of dicitabine combined with CHG regimen in the senile acute myeloid leukemia treatment

摘要:

目的 回顾性分析地西他滨联合CHG方案治疗老年急性髓系白血病（AML）的疗效及安全性，为临床用药提供更多选择。方法 选取2012年1月—2019年4月绍兴市人民医院收治的53例老年AML患者。 观察组28例，采用地西他滨联合CHG方案（重组人粒细胞集落刺激因子+高三尖杉酯+阿糖胞苷），对照组25例，采用去甲氧柔红霉素联合阿糖胞苷方案。比较两组疗效、不良反应、血制品输注情况及生存分析。结果 第二疗程后观察组完全缓解率64.3%，有效率75.0%，对照组完全缓解率56.0%，有效率64.0%，两组差异无统计学意义（P?>0.05）；两组患者第一疗程化疗后，相比对照组，观察组粒细胞缺乏时间短（P?<0.05），PLT<20×109/L的时间短（P?<0.05），红细胞和血小板输注少（P?<0.05）；非血液学不良反应，观察组3～4级 感染少（P?<0.05），肺部感染发生率低（P?<0.05）。两组无进展生存期及总生存期比较，差异无统计学意义（P?> 0.05）。结论 地西他滨联合CHG方案治疗老年AML疗效确切，骨髓抑制程度轻，不良反应较少，患者耐受性优于传统方案。

Abstract:

Objective To provide more choices for clinical medication by retrospectively analyzing the efficacy and safety of dicitabine combined with CHG regimen in treating the senile acute myeloid leukemia (AML). Methods The elderly patients with AML who underwent initial treatment in our hospital from January 2012 to April 2019 were selected. 28 cases were involved in the observation group, which were treated with dicitabine combined with CHG (recombinant granulocyte colony stimulating factor + homoharringtonate + cytarabine), as the induction remission regimen, while 25 cases involved in the control group were treated with IA as the induction remission regimen. Followingly, the observation and survival analysis of efficacy, adverse reactions, and blood product transfusion of the patients in the two groups were performed. Results After 2 courses of treatment, the CR rate and effective rate of the observation group and the control group was 64% and 75%, and 56% and 64%, respectively; the difference between the two groups had no statistical significance (P?>?0.05). After the first course of chemotherapy in the two groups, compared with the control group, the observation group had less agranulocytosis time (P??0.05). Conclusion Dicitabine combined with CHG regimen is effective in the treatment of elderly patients with AML, with mild bone marrow suppression and fewer adverse reactions, and patient's tolerance with the treatment regimen is better than that with the traditional regimen.