Yang Xue-Liang, Wu Ya-Mei, Cao Yong-Bin, Li Xiao-Hong, Xu Li-Xin, Liu Zhou-Yang, Liu Bei, Yan Bei, Li Song-Wei, DA Wan-Ming, Wu Xiao-Xiong
Department of Hematology, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China.
Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2015 Aug;23(4):1056-61. doi: 10.7534/j.issn.1009-2137.2015.04.030.
To investigate the therapeutic efficacy and side effects of treating patients with myelodysplastic syndrome-RAEB (MDS-RAEB) and with refractory acute myeloid leukemia (AML) by using decitabine combined with CAG regimen.
Clinical data of 21 patients with MDS-RAEB or refractory AML from July 2011 to July 2014 were analyzed retrospectively. Among 21 patients there were 4 cases of MDS-RAEB and 17 cases of refractory AML; 12 cases were beyond 60 years old; 13 cases had high-risk karyotypes. All the patients received decitabine combined with CAG regimen consisting of decitabine 20 mg/(m(2) · d), d 1-5; aclarubicin 10 mg/d, d 6-13; cytarabine 20 mg/d, d 6-19; G-CSF 300 µg/d, d 6-19.
After 1 cycle of treatment with DCAG regimen, the outcome of 21 patients showed that 8 cases achieved complete remission (42.1%), 8 cases achieved partial remission (42.1%), 2 cases achieved hematologic improvement, 1 cases achieved non-remission and 2 cases died; and the 1 year overall survival rate was 67.5%. The outcome of 12 patients beyond 60 years old showed that 6 cases achieved complete renission (60%, 6/10), and the 1 year overall survival rate was 62.5%. The outcome of 13 patients with high-risk karytype showed that 6 cases achieved complete renission (54.5%, 6/11), and the 1 year overall survival rate was 61.5%. The main adverse event was myelosuppression, and non-hematological toxicity included liver dysfunction and gastrointestinal tract reaction.
Decitabine combined with CAG regimen is effective and safe for treatment of MDS-RAEB and refractory AML patients, which can prolong lives of patiens with refractory hematological diseases.
探讨地西他滨联合CAG方案治疗骨髓增生异常综合征-难治性贫血伴原始细胞过多型（MDS-RAEB）及难治性急性髓系白血病（AML）的疗效及不良反应。
回顾性分析2011年7月至2014年7月收治的21例MDS-RAEB或难治性AML患者的临床资料。21例患者中，MDS-RAEB 4例，难治性AML 17例；年龄>60岁12例；高危核型13例。所有患者均接受地西他滨联合CAG方案治疗，具体为地西他滨20 mg/(m²·d)，第15天；阿克拉霉素10 mg/d，第613天；阿糖胞苷20 mg/d，第619天；粒细胞集落刺激因子（G-CSF）300 μg/d，第619天。
21例患者经DCAG方案1个周期治疗后，完全缓解8例（42.1%），部分缓解8例（42.1%），血液学改善2例，未缓解1例，死亡2例；1年总生存率为67.5%。年龄>60岁的12例患者中，完全缓解6例（60%，6/10），1年总生存率为62.5%。高危核型的13例患者中，完全缓解6例（54.5%，6/11），1年总生存率为61.5%。主要不良事件为骨髓抑制，非血液学毒性包括肝功能损害和胃肠道反应。
地西他滨联合CAG方案治疗MDS-RAEB及难治性AML患者有效、安全，可延长难治性血液病患者的生存期。
