维奈克拉联合小剂量阿柔比星、阿糖胞苷方案治疗老年急性髓系白血病的疗效观察

Therapeutic efficacy of venetoclax combined with low-dose AA regimen for acute myeloid leukemia in the elderly

摘要:

目的 探讨维奈克拉联合小剂量阿柔比星、阿糖胞苷（AA）方案治疗老年急性髓系白血病（AML）的疗效。方法 回顾性分析2017年2月—2020年12月青海省人民医院治疗的83例老年AML患者的临床资料。其中，62例采用小剂量阿柔比星、阿糖胞苷治疗作为对照组，21例采用维奈克拉联合小剂量AA方案治疗作为研究组。比较两组近期疗效、外周血p53含量，观察两组不良反应及血制品输注情况，分析两组治疗期间药物安全性及治疗后6个月生存情况。结果 研究组客观缓解率高于对照组（P <0.05）。研究组治疗前后p53的差值高于对照组（P <0.05）。研究组粒细胞缺乏时间、血小板计数< 20×10⁹/L时间短于对照组（P <0.05），细胞输注量、血小板输注量少于对照组（P <0.05）。两组感染、皮疹、肝功能损伤、胃肠道反应发生率比较，差异均无统计学意义（P >0.05）。研究组死亡1例，对照组死亡7例；两组患者总存活率曲线比较，差异无统计学意义（P >0.05）。结论 维奈克拉联合小剂量AA方案治疗老年AML疗效显著，且安全可靠。

Abstract:

Objective To explore the therapeutic efficacy of venetoclax combined with low-dose aclarubicin and cytosine arabinoside (AA) regimen for acute myeloid leukemia (AML) in the elderly.Methods The clinical data of 83 elderly AML patients treated in our hospital from February 2017 to December 2020 were retrospectively analyzed. Among them, 62 were treated with low-dose AA (recorded as the control group), and the other 21 cases were treated with venetoclax combined with low-dose AA (recorded as the study group). The short-term therapeutic efficacy and peripheral blood p53 content of the two groups were compared. The adverse reactions and the transfusion of blood products in the two groups were observed, and the drug safety during the treatment period and the survival status after six months of treatment in the two groups were analyzed.Results The objective response rate of the study group was higher than that of the control group (P < 0.05). The difference of p53 before and after the treatment in the study group was higher than the that in the control group (P < 0.05). The time to agranulocytosis and the time to platelet count < 20×10⁹/L were shorter, and the amount of blood cell transfusion and that of platelet transfusion were lower in the study group compared with the control group (P < 0.05). There was no significant difference in the incidence of infection, rashes, liver damage, and gastrointestinal adverse drug reactions between the two groups (P > 0.05). There was 1 death in the study group and 7 deaths in the control group. In addition, there was no significant difference in the overall survival curve between the two groups (P > 0.05).Conclusions The venetoclax combined with low-dose AA regimen is effective and safe for the treatment of AML in the elderly.