摘要
目的 探讨地西他滨联合芦可替尼方案治疗初诊慢性粒单核细胞白血病患者的价值。方法 选取2017年8月至2019年8月辽宁省健康产业集团阜新矿总医院收治的慢性粒单核细胞白血病患者10例,采用地西他滨联合芦可替尼治疗,对患者的临床特征进行记录,评估治疗效果,记录治疗期间不良反应发生情况,系统性的分析地西他滨联合芦可替尼治疗的价值。结果 经治疗后,9例患者疗效评定结果为有效,包含完全改善4例、血液学改善3例、骨髓缓解2例,余1例患者疗效评定结果为无效,随访期间死亡。在治疗期间,8例患者出现骨髓抑制问题,骨髓抑制期在2个月内,4例患者出现腹泻症状,4例患者出现肺部感染,3例患者出现便秘症状。上述症状经及时发现并开展有效的针对性治疗后均得到改善,未对治疗效果产生负面影响。选取患者中存在CBL基因突变者8例、SRSF2基因突变者6例,TET2基因突变者6例,ASXL1基因突变者4例,经治疗后基因突变检测结果显示上述问题均得到改善,未得到改善的1例CBL基因突变患者最终病情进展死亡。结论 在初诊慢性粒单核细胞白血病患者的治疗中联合使用地西他滨与芦可替尼,可在很大程度上改善患者的临床症状,提高患者的生存质量,且治疗期间不会引发严重不良反应,安全性较高。
Objective To study the value of descitabine combined with lucotinib in the treatment of chronic myelomonocytic leukemia.Methods From August 2017 to August 2019, a total of 10 patients with chronic myelomonocytic leukemia were selected, who were treated with dicetabine and lucotinib. The clinical characteristics of the selected patients were measured, the therapeutic effect was evaluated, the adverse reactions during the treatment were recorded, and the application value of dicetabine combined with lucotinib was systematically analyzed. Results After treatment, 9 patients were effective after treatment, including 4 cases of complete improvement, 3 cases of Hematology improvement, 2 cases of bone marrow remission, the remaining 1 case was invalid, and died during follow-up. During the treatment, 8 patients had myelosuppression, the myelosuppression period was within 2 months, 4 patients had diarrhea, 4 patients had lung infection, 3 patients had constipation. The above symptoms were improved after timely detection and effective targeted treatment, but had no negative impact on the treatment effect. Eight patients with CBL gene mutation, 6 patients with SRSF2 gene mutation, 6 patients with TET2 gene mutation, 4 patients with ASXL1 gene mutation were selected. After treatment, the gene mutation detection results showed that the above problems were improved, and one patient with CBL gene mutation who did not improve eventually died. Conclusion The combination of dicetabine and lucotinib in the treatment of newly diagnosed chronic myelomonocytic leukemia patients can improve the clinical symptoms and quality of life of the patients to a large extent,and will not cause serious adverse reactions during the treatment, with high safety.
作者
孙秋岩
高九青
张丽翡
张艺露
蔡威
SUN Qiuyan;GAO Jiuqing;ZHANG Lifei;ZHANG Yilu;CAI Wei(Liaoning Health Industry Group Fuxin Mining General Hospital,Fuxin 123000,China)
出处
《中国医药指南》
2022年第11期79-81,共3页
Guide of China Medicine
关键词
慢性粒单核细胞白血病
初诊
地西他滨
芦可替尼
Chronic myelomonocytic leukemia
Initial diagnosis
Decitabine
Ruxolitinib
