摘要
目的探讨阿扎胞苷联合HAG方案(高三尖杉酯碱+阿糖胞苷+重组人粒细胞集落刺激因子)或半量HAG方案治疗老年急性髓系白血病(AML)的疗效与安全性。方法回顾性分析南京医科大学附属淮安第一医院2016年1月至2021年10月32例采用阿扎胞苷联合HAG方案(AZA+HAG组)和阿扎胞苷联合半量HAG方案(AZA+半量HAG组)化疗的老年AML患者的临床资料,包括11例复发及21例初治患者。评价治疗方案的安全性与疗效,观察指标包括临床特征、治疗反应、不良反应、患者无复发生存期(RFS)与总生存期(OS)。结果AZA+HAG组与AZA+半量HAG组的完全缓解率(CRR)、总反应率(ORR)、1疗程微小残留病(MRD)转阴率比较,差异无统计学意义(P>0.05)。两组出血、感染、过敏反应、消化道反应、脏器功能不全、脱发、骨髓抑制及化疗相关死亡发生率比较,差异无统计学意义(P>0.05)。AZA+HAG组与AZA+半量HAG组的中位RFS分别为13、28个月,两组的中位OS分别为13、21个月,两组RFS、OS比较,差异无统计学意义(P=0.701,P=0.983)。初治与复发患者中位OS分别为9个月和30、5个月,差异有统计学意义(P=0.047)。结论阿扎胞苷联合HAG方案或半量HAG方案适用于初治或复发老年不能耐受强烈化疗的AML患者,可以延长老年AML患者的RFS与OS,是初治或复发老年AML患者的一种治疗选择。
Objective To investigate the efficacy and safety of azacitidine combined with HAG(homoharringtonine+cytarabine+recombinant human granulocyte colony-stimulating factor)or half-dose HAG in the treatment of elderly acute myeloid leukemia(AML).Methods The clinical data of 32 elderly AML patients(including 11 relapsed and 21 treatment-naive patients)treated with chemotherapy with azacitidine combined with HAG(AZA+HAG group)and azacitidine combined with half-dose HAG(AZA+half-dose HAG group)at the Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University from January 2016 to October 2021 were retrospectively analyzed.The clinical characteristics,treatment response,adverse reactions,relapse-free survival(RFS)and overall survival(OS)of patients were observed to evaluate the safety and efficacy of the treatment regimens.Results There was no significant difference in complete response rate(CRR),total response rate(ORR)and negative rate of minimal residual disease(MRD)in one course between AZA+HAG group and AZA+half-dose HAG group(P>0.05).There was no significant difference between the two groups in the incidence of bleeding,infection,allergic reaction,gastrointestinal reaction,organ function,alopecia,bone marrow inhibitor and chemotherapy-related death(P>0.05).The median RFS of AZA+HAG group and AZA+half-dose HAG group were 13 and 28 months respectively,and the median OS of the two groups were 13 and 21 months respectively.There was no significant difference in RFS and OS between the two groups(P=0.701,P=0.983).The median OS of newly treated and relapsed patients were 9 and 30.5 months,respectively,and the difference between the two groups was statistically significant(P=0.047).Conclusion Azacitidine combined with HAG or half-dose HAG is suitable for treatment-naive and relapsed elderly AML patients who cannot tolerate intense chemotherapy,and can prolong RFS and OS in such patients,and therefore is an additional treatment option for treatment-n aive or relapsed elderly AML patients.
作者
周立涛
ZHOU Litao(Department of Hematology,the Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University,Jiangsu Huai'an 223300,China)
出处
《中国医药科学》
2022年第18期147-151,169,共6页
China Medicine And Pharmacy
