Ramos-Peñafiel Christian Omar, Martínez-Murillo Carlos, Santoyo-Sánchez Adrián, Jiménez-Ponce Fiacro, Rozen-Fuller Etta, Collazo-Jaloma Juan, Olarte-Carrillo Irma, Martínez-Tovar Adolfo
Departamento de Hematología, Hospital General de México, Secretaría de Salud. Distrito Federal, México.
Rev Med Inst Mex Seguro Soc. 2014 May-Jun;52(3):270-5.
Recently it has been reported a benefit effect with the use of metformin in patients with malignant disease. Our objective was to evaluate the effect of adding metformin to chemotherapy regimen over the percentage of early relapse in acute lymphoblastic leukemia.
A prospective, longitudinal and experimental study was performed in patients with de novo acute lymphoblastic leukemia enrolled in the Hospital General de México. They were divided in two groups: first group received chemotherapy + metformin (850 mg three times a day); second group only received standard chemotherapy. The sample was randomized 3:1 in favor of the second group.
93 patients were included (73 treated with chemotherapy + metformin and 20 received standard chemotherapy), with 303 ± 53 days of follow-up. Complete remission was higher in the group without metformin (81.3 % [n = 61] versus 70 % [n = 14]), which also presented more patients with relapse (47.9 % versus 25 %). Overall survival at one year was of 68 % and free survival disease was 64 %, without significant differences between groups. Absence of metformin was the only variable of adverse prognostic considered significant (p = 0.55). Cox regression showed that adding metfomin reduced 56 % the risk of relapse.
The adding metformin to the treatment of leukemias showed that was useful in our research. However, randomized and double-blind studies must be designed in order to express final recommendations about its use.
最近有报道称二甲双胍对恶性疾病患者有益。我们的目的是评估在急性淋巴细胞白血病化疗方案中添加二甲双胍对早期复发率的影响。
对墨西哥总医院收治的初发急性淋巴细胞白血病患者进行了一项前瞻性、纵向和实验性研究。他们被分为两组:第一组接受化疗+二甲双胍(850毫克,每日三次);第二组仅接受标准化疗。样本以3:1随机分配,倾向于第二组。
纳入93例患者(73例接受化疗+二甲双胍治疗,20例接受标准化疗),随访303±53天。未使用二甲双胍的组完全缓解率更高(81.3%[n = 61]对70%[n = 14]),该组复发患者也更多(47.9%对25%)。一年总生存率为68%,无病生存率为64%,两组之间无显著差异。未使用二甲双胍是唯一被认为具有显著不良预后的变量(p = 0.55)。Cox回归显示,添加二甲双胍可降低56%的复发风险。
在白血病治疗中添加二甲双胍在我们的研究中显示是有用的。然而,必须设计随机双盲研究以给出关于其使用的最终建议。