摘要
目的:探究地西他滨联合FLAG化疗方案在急性髓系白血病(AML)异基因造血干细胞移植(allo-HSCT)后复发患者中的治疗效果。方法:回顾性分析2014年1月至2020年6月95例allo-HSCT治疗后复发的AML患者临床资料,根据治疗方案不同,95例患者分为联合组51例与FLAG组44例,联合组予以地西他滨(5~7mg/m^(2)/d皮下注射,d1~d5)联合FLAG方案治疗,FLAG组行FLAG方案治疗,两组均有相同对症支持治疗,治疗4周后复查疗效,并记录两组化疗毒副反应、对症支持治疗情况,以2022年6月31日为随访截止时间,采用Kaplan-meier行生存分析,记录两组总生存期及2年生存率。结果:治疗后,联合组完全缓解率(CR)、总有效率(ORR)分别为50.98%、80.39%,较FLAG组的34.09%、56.82%高,其中ORR比较差异有统计学意义(P<0.05)。化疗期间,两组不良反应中骨髓抑制(Z=0.18,P=0.855)、胃肠道反应(Z=0.63,P=0.531)、肝损伤(Z=1.06,P=0.288)、出血(Z=0.61,P=0.540)、肺部感染(Z=0.33,P=0.739)分度比较差异均无统计学意义(P>0.05);两组去白红细胞悬液、血小板、抗生素应用率比较差异无统计学意义(P>0.05)。截至2022年6月31日,联合组中位总生存时间为14.5(1.2~34.8)个月,2年总生存率为41.18%,较FLAG组的11.4(0.9~26.9)个月、22.73%高,但Log-rank检验显示,两组生存率比较差异无统计学意义(Log-rankχ^(2)=3.758,P=0.053)。结论:在FLAG方案治疗基础上,联合地西他滨治疗allo-HSCT术后复发AML患者可取得更好近期疗效,且未增加化疗不良反应。
Objective:To explore the therapeutic effects of decitabine combined with FLAG chemotherapy regimen on patients with recurrent acute myeloid leukemia(AML)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:The clinical data of 95 patients with recurrent AML after allo-HSCT treatment between January 2014 and June 2020 were retrospectively analyzed.According to different treatment regimens,95 patients were divided into combined group(51 cases)and FLAG group(44 cases).Combined group was given decitabine(5~7mg/m^(2)/d,subcutaneous injection,d1~d5)combined with FLAG regimen,and FLAG group was treated with FLAG regimen,and the two groups had the same symptomatic and supportive treatment.The efficacy was reviewed after 4 weeks of treatment,and the toxic and side effects of chemotherapy and status of symptomatic and supportive treatment were recorded in the two groups.June 31,2022 was the deadline for follow-up,and Kaplan-meier survival analysis was used to record the overall survival time and 2-year survival rate in the two groups.Results:After treatment,the complete remission rate(CR)and overall response rate(ORR)with 50.98%and 80.39%in combined group were higher than those in FLAG group with 34.09%and 56.82%.There was a statistically significant difference in the ORR(P<0.05).During chemotherapy,there were no statistically differences between the two groups in terms of adverse reactions such as bone marrow suppression(Z=0.18,P=0.855),gastrointestinal reactions(Z=0.63,P=0.531),liver injury(Z=1.06,P=0.288),bleeding(Z=0.61,P=0.540),and pulmonary infection(Z=0.33,P=0.739)(P>0.05).There was no statistically significant difference in the comparison of the rates of deleterious erythrocyte suspension,platelets,and antibiotic application between the 2 groups(P>0.05).As of June 31,2022,the median overall survival time and 2-year overall survival rate with 14.5(1.2-34.8)months and 41.18%in combined group were higher than those in FLAG group with 11.4(0.9~26.9)months and 22.73%.However,Log-rank test showed t
作者
吴燕
刘艳
陈羽
WU Yan;LIU Yan(West China Hospital,Sichuan University,Sichuan Chengdu 610041,China)
出处
《河北医学》
CAS
2023年第10期1683-1688,共6页
Hebei Medicine
基金
四川省科技计划项目,(编号:2020YJ0021)。
关键词
急性髓系白血病
异基因造血干细胞移植
复发
地西他滨
Acute myeloid leukemia
Allogeneic hematopoietic stem cell transplantation
Recur-rence
Decitabine
