单药地西他滨治疗复发难治性急性髓系白血病的疗效
Efficacy of single-agent decitabine in relapsed and refractory acute myeloid leukemia.
作者信息
Khan Niloufer, Hantel Andrew, Knoebel Randall W, Artz Andrew, Larson Richard A, Godley Lucy A, Thirman Michael J, Liu Hongtao, Churpek Jane E, King Darren, Odenike Olatoyosi, Stock Wendy
机构信息
a Departments of Medicine and Pediatrics , The University of Chicago Medicine , Chicago , IL , USA.
b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
出版信息
Leuk Lymphoma. 2017 Sep;58(9):1-7. doi: 10.1080/10428194.2017.1289524. Epub 2017 Feb 20.
Improving therapy for relapsed/refractory AML remains a challenge. We performed a retrospective analysis of outcomes following decitabine treatment in 34 patients with relapsed/refractory AML (median age, 62; median Charlson comorbidity score, 6). Decitabine, 20 mg/m daily, was given in 5- (25%) or 10-day (75%) cycles. Overall response rate (OR) was 30% with 21% complete remission and 9% partial remission rate. Patients with therapy-related myeloid neoplasm (t-MN) and secondary AML had a significantly higher OR compared to those with de novo AML (70 vs. 30%; p = .02). Median overall survival of all patients was 8.5 months. Median survival in patients with t-MN or secondary AML was 12.4 months compared to 8 months in those with de novo AML (p = .20). Fifteen (44%) patients proceeded to hematopoietic stem cell transplant. These data support using 10-day treatment cycles of decitabine in patients with relapsed/refractory AML, particularly for those with secondary or therapy-related AML.
改善复发/难治性急性髓系白血病（AML）的治疗仍然是一项挑战。我们对34例复发/难治性AML患者（中位年龄62岁；中位查尔森合并症评分6分）接受地西他滨治疗后的结局进行了回顾性分析。地西他滨剂量为每日20mg/m²，采用5天（25%）或10天（75%）的疗程给药。总缓解率（OR）为30%，其中完全缓解率为21%，部分缓解率为9%。与初发AML患者相比，治疗相关髓系肿瘤（t-MN）和继发性AML患者的OR显著更高（70%对30%；p = 0.02）。所有患者的中位总生存期为8.5个月。t-MN或继发性AML患者的中位生存期为12.4个月，而初发AML患者为8个月（p = 0.20）。15例（44%）患者进行了造血干细胞移植。这些数据支持在复发/难治性AML患者中使用地西他滨10天治疗疗程，特别是对于继发性或治疗相关AML患者。
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