摘要
目的比较阿扎胞苷联合维奈克拉或CAG方案对初治老年急性髓系白血病(AML)的疗效和安全性。方法回顾性队列研究。回顾性分析2018年5月至2023年8月大同市第五人民医院收治的34例老年初治AML患者的临床资料。依据治疗方案将患者分为维奈克拉组(阿扎胞苷+维奈克拉,17例)和CAG组(阿扎胞苷+CAG方案,17例)。比较两组患者的临床特征、疗效、不良反应及生存情况。结果两组临床资料比较,差异均无统计学意义(均P>0.05)。维奈克拉组完全缓解率和客观反应率分别为70.6%(12/17)、82.4%(14/17),均高于CAG组的47.1%(8/17)、64.7%(11/17),但两组差异均无统计学意义(χ2=2.00,P=0.163;χ2=2.00,P=0.244)。患者随访时间[M(Q1,Q3)]为25.4个月(7.2个月,60.3个月)。至随访结束,34例患者中19例生存(维奈克拉组13例,CAG组6例),15例死亡(维奈克拉组4例,CAG组11例)。维奈克拉组和CAG组中位总生存时间分别为14.22个月(95%CI:8.2~60.3个月)和10.56个月(95%CI:7.2~50.2个月),中位无进展生存时间分别为9.97个月(95%CI:5.4~40.5个月)和6.82个月(95%CI:5.0~36.2个月),两组总生存、无进展生存时间差异均无统计学意义(均P>0.05)。维奈克拉组和CAG组分别有16、14例患者发生3~4级血液学不良反应。两组粒细胞缺乏时间、血小板缺乏时间、感染及出血发生率比较,差异均无统计学意义(均P>0.05)。结论阿扎胞苷联合维奈克拉或CAG方案治疗老年初治AML患者均有较好的临床效果和安全性。
Objective To compare the efficacy and safety of azacitidine combined with venetoclax or CAG regimen in the treatment of newly treated elderly patients with acute myeloid leukemia(AML).Methods A retrospective cohort study was conducted.The clinical data of 34 newly treated elderly patients with AML treated in the Fifth People's Hospital of Datong from May 2018 to August 2023 were retrospectively analyzed.According to the treatment regimen,all patients were divided into venetoclax group(azacitidine+venetoclax,17 cases)and CAG group(azacitidine+CAG regimen,17 cases).The clinicopathological characteristics,efficacy,adverse reactions and survival of the both groups were compared.Results There were no statistically significant differences in the clinical data of both groups(all P>0.05).The complete remission(CR)rate and the objective response rate(ORR)in venetoclax group were higher than those in CAG group[CR:70.6%(12/17)vs.47.1%(8/17);ORR:82.4%(14/17)vs.64.7%(11/17)],while the differences in CR and ORR were not statistically significant(χ2=2.00,P=0.163;χ2=2.00,P=0.244).The follow-up time[M(Q1,Q3)]was 25.4 months(7.2 months,60.3 months).At the end of follow-up,19 of 34 patients survived(13 cases in venetoclax group and 6 cases in CAG group);15 died(4 cases in venetoclax group and 11 cases in CAG group).The median overall survival(OS)time was 14.22 months(95%CI:8.2-60.3 months)and 10.56 months(95%CI:7.2-50.2 months),respectively in venetoclax group and CAG group;the median progression-free survival(PFS)time was 9.97 months(95%CI:5.4-40.5 months)and 6.82 months(95%CI:5.0-36.2 months),respectively,and there were no statistically significant differences in OS and PFS between the two groups(all P>0.05).Grade 3-4 hematological adverse reactions occurred in 16 and 14 patients in venetoclax group and CAG group,respectively.There were no significant differences in granulocyte deficiency time,platelet deficiency time,infection and bleeding incidence between the two groups(all P>0.05).Conclusions Azacitidine combined with venet
作者
葛文军
葛宋钰
张向臣
李霞
王丽
段建宇
杨晶
马一栋
Ge Wenjun;Ge Songyu;Zhang Xiangchen;Li Xia;Wang Li;Duan Jianyu;Yang Jing;Ma Yidong(Department of Hematology,the Fifth People's Hospital of Datong,Datong 037009,China;The First Clinical College of China Medical University,Shenyang 110000,China;Department of Oncology Radiotherapy,the Fifth People's Hospital of Datong,Datong 037009,China)
出处
《肿瘤研究与临床》
CAS
2024年第5期356-360,共5页
Cancer Research and Clinic
