摘要
目的探讨地西他滨(DAC)对复发难治急性白血病的辅助治疗效果。方法选取商丘市第一人民医院2013年2月—2016年1月收治的64例复发难治性急性髓系白血病(AML)患者为研究对象,采用随机数字表法分为实验组和对照组,各32例。对照组给予对症支持治疗和CAG[阿糖胞苷(Ara-C)+阿克拉霉素(Acla)+粒细胞集落刺激因子(G-CSF)]化疗方案,实验组在此基础上给予DAC治疗。比较两组治疗前后生化指标[白细胞(WBC)、血小板(Plt)、血红蛋白(Hb)]检查结果差异,并记录两组疗效、不良反应及预后情况(复发率、死亡率)差异。结果治疗4周后,两组Plt、Hb检测结果均较治疗前升高(P<0.05),且实验组高于对照组(P<0.05);WBC检测结果较治疗前降低(P<0.05),且实验组低于对照组(P<0.05)。实验组治疗4周后CR率与总有效率分别为81.25%、90.63%,均较对照组高(P<0.05)。两组不良反应发生率比较无统计学意义(P>0.05)。实验组治疗1年内复发率与死亡率均较对照组低(P<0.05)。结论 DAC应用于辅助CAG方案治疗复发难治性AML可提高治疗效果且不良反应较少,对改善血细胞水平、提高患者预后生存质量有积极意义。
Objective To investigate the effect of adjunctive therapy of decitabine（ DAC） on relapsed and refractory acute leukemia. Methods Totally 64 patients with relapsed and refractory acute myeloid leukemia（ AML） treated in our hospital were selected as the research objects,and they were randomly divided into experimental group（ 32 cases） and control group（ 32 cases）. Both groups were given symptomatic and supportive treatment,and CAG[cytosine arabinoside（ Ara-C） ＋ aclacinomycin（ Acla） ＋ granulocyte colony-stimulating factor（ G-CSF） ]chemotherapy regimen,besides,the experimental group was given additional DAC treatment. The differences of biochemical indexes [white blood cell（ WBC）,platelet（ Plt）,hemoglobin（ Hb） ]in the two groups were compared before and after treatment,the curative effects,adverse reactions and prognoses（ recurrence rate and mortality rate） in the two groups were recorded.Results Four weeks after treatment,the test results of Hb and Plt in the two groups were significantly increased（ P〈 0. 05）,and the increase in the experimental group was higher than that in control group（ P〈 0. 05）; The test results of WBC in the two groups were significantly decreased（ P〈 0. 05）,and the decrease in the experimental group was higher than that in the control group（ P〈 0. 05）; The CR rate and total effective rate in the experimental group were higher than those in the control group（ P〈 0. 05）. There was no significant difference in adverse reactions between the two groups（ P〈 0. 05）. The recurrence rate and mortality rate of the experimental group were lower than those of the control group within 1 years（ P〈 0. 05）. Conclusion DAC assisted CAG therapy which has positive significance in improving the blood cell levels,prognoses and survival quality of patients,can improve the efficacy of relapsed and refractory AML and reduce adverse reactions.
作者
田颖
陈淑霞
胡青竹
TIAN Ying;CHEN Shu-xia;HU Qing-zhu(Department of Hematology,Shangqiu the First People ~ Hospital,Shangqiu,Henan 476100,China)
出处
《医药论坛杂志》
2018年第7期66-68,共3页
Journal of Medical Forum
关键词
地西他滨
难治性
急性髓系白血病
治疗方案
疗效
Decitabine
Refractory
Acute myeloid leukemia
Regimen Therapy
Efficacy analysis
