摘要
目的观察减低剂量阿扎胞苷治疗中高危骨髓增生异常综合征(MDS)及骨髓增生异常综合征/骨髓增殖性肿瘤(MDS/MPN)患者的临床疗效。方法选取2018年12月至2021年1月安徽医科大学第一附属医院收治中高危MDS(24例)及MDS/MPN(13例)患者,采取减低剂量阿扎胞苷[60 mg/(m^(2)·d),连续7 d,28 d为1个疗程]治疗,分析临床疗效与不良反应。结果中位疗程为2个疗程。32例接受二代基因测序的患者中,27例(84.38%)存在基因突变。治疗总反应率为54.05%,阿扎胞苷治疗≥3个疗程的患者总反应率高于<3个疗程者(80.00%vs 36.36%,P=0.018)。中位生存期为15.00个月。不良反应包括骨髓抑制、感染及胃肠道反应。结论减低剂量阿扎胞苷治疗中高危MDS及MDS/MPN患者具有良好的有效性及安全性,多疗程治疗可提高临床疗效。
Objective To observe the clinical efficacy of reduced-dose azacitidine on patients with intermediate and high risk myelodysplastic syndrome(MDS)and myelodysplastic syndrome/myeloproliferative neoplasms(MDS/MPN).Methods Twenty-four patients with MDS and thirteen patients with MDS/MPN from the First Affiliated Hospital of Anhui Medical University between December 2018 and January 2021 were treated with reduced-dose azacitidine[60 mg/(m^(2)·d)for 7 days per 28-day cycle],then the clinical efficacy and adverse effects were analyzed.Results The median number of cycles was two.Next-generation gene sequence was performed among 32 patients,and mutations in genes were identified in 27 patients(84.38%).54.05%of patients responded to the reduced-dose azacitidine.Patients who received at least three cycles had a better response to azacitidine than those who received fewer than three cycles(80.00%vs 36.36%,P=0.018).The median survival was 15.00 months in the follow-up period.Adverse effects included myelosuppression,infection,and gastrointestinal reaction.Conclusions Reduced-dose azacitidine is effective and safe for patients with intermediate risk or high risk MDS and MDS/MPN,and the clinical efficacy is better in patients who have received multiple cycles.
作者
龙章彪
葛健
倪婧
刘沁华
曾庆曙
夏瑞祥
LONG Zhangbiao;GE Jian;NI Jing(Department of Hematology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《安徽医学》
2021年第9期961-965,共5页
Anhui Medical Journal
基金
国家自然科学基金(项目编号:81900118)。
