摘要
目的探讨老年骨髓增生异常综合征(MDS)转化为急性髓系白血病(AML)患者采取地西他滨与预激改良方案(IAG)联合治疗的实际效果,以便为临床治疗提供参考。方法选择本院2009年1月至2017年12月收治的50例老年MDS转化为AML患者作为研究对象,入组对象有完整资料,愿意配合研究且签署了知情同意书。所有患者均接受地西他滨与预激改良方案联合治疗,两组患者均治疗≥2个疗程,且均随访半年以上。治疗2个疗程后评价疗效,记录不良反应(对两个疗程期间不良反应进行比较分析),同时根据治疗有效与无效分组,比较两组性别、年龄、预后FLT3基因、染色体核型差异性。结果本次研究50例患者经2个疗程治疗后评价疗效,显示完全缓解18例、部分缓解22例、未缓解10例,有效率80.00%;经统计学分析有效组与无效组患者性别、年龄、预后FLT3基因、染色体核型可以看出,两组在预后FLT3基因上差异有统计学意义(P<0.05),其余差异无统计学意义;治疗第1个疗程时,感染率高达84.00%,治疗第2个疗程时感染率为70.00%,2个疗程感染率表差异有统计学意义(P<0.05),但其余如骨髓抑制、恶心呕吐、背部疼痛不适、肝功能损伤比较差异无统计学意义。结论地西他滨与预激改良方案联合治疗MDS转化为急性髓系白血病患者有一定的效果,随着疗程增加,安全性提高,主要不良反应为感染、骨髓抑制,对症处理后缓解或消失,同时其疗效可能和预后FLT3基因有关,在实际治疗期间需加强重视。
Objective To investigate the effect of combination therapy of dietabine and (IAG) in elderly patients with myelodysplastic syndrome (MDS) converted into acute myeloid leukemia (AML) in order to provide reference for clinical treatment. Methods 50 elderly patients with MDS converted into AML from January 2009 to December 2017 were selected as the study objects. The subjects were willing to cooperate with the study and sign the informed consent. All patients were treated with combination of dietabine and preexcitation regimen. Both groups were treated with more than 2 courses of treatment and were followed up. More than half a year. After two courses of treatment, we evaluated the curative effect, recorded the adverse reactions (compared and analyzed the adverse reactions during the two courses of treatment), and compared the sex, age, prognosis of FLT3 gene and chromosome karyotype difference between the two groups according to the effective and ineffective groups. Results After two courses of treatment, 50 patients in this study were evaluated for their curative effects, including 18 cases of complete remission, 22 cases of partial remission, 10 cases of non-remission, the effective rate was 80.00%. The effective group and ineffective group were of gender, age, and age. Prognostic FLT3 gene, chromosome karyotype can be seen, the two groups in the prognosis of FLT3 gene differences are significant. The infection rate in the first course of treatment was as high as 84.00 and the infection rate in the second course of treatment was 70.00%.The infection rate of the two courses was significantly different (P<0.05), but the rest were as follows: bone marrow depression, nausea and vomiting. There was no difference in back pain and liver function injury. Conclusion The combination of dicitabine and preexcitation regimen is effective in the treatment of patients with acute myeloid leukemia from MDS to acute myeloid leukemia. With the increase of course of treatment, the safety is improved. The main adverse reactions are i
作者
刘文霞
LiuWenxia(Department of Hematology,Yingkou City Central Hospital,Liaoning Province,Yingkou,Liaoning,115000,China)
出处
《当代医学》
2019年第17期13-15,共3页
Contemporary Medicine
