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低剂量地西他滨联合CAG方案治疗骨髓增生异常综合征-难治性贫血伴原始细胞增多(MDS-RAEB)的临床疗效

[Clinical Efficacy of Low-dose Decitabine Combined with CAG Regimen in Patients with Myelodysplastic Syndrome-refractory Anemia with Excess Blasts(MDS-RAEB)].

作者信息

Wang Meng, Han Hao-Hao, Guo Rong, Liu Yan-Fang, Jiang Zhong-Xing, Sun Hui

机构信息

Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.

Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Oct;25(5):1482-1486. doi: 10.7534/j.issn.1009-2137.2017.05.035.

Abstract

OBJECTIVE

To investigate the clinical efficacy of low-dose decitabine combined with CAG regimen in patients with myelodysplastic syndrome-refractory anemia with excess blasts (MDS-RAEB) through retrospective analysis.

METHODS

Thirty-six patients with MDS-RAEB who ever received low-dose decitabine combined with CAG regimen were enrolled into decitabine + CAG group and 40 patients with MDS-RAEB treated by decitabine alone in our center were enolled into the control group. The clinical characteristics, efficacy and adverse reactions (AE) were compared between the 2 groups.

RESULTS

Compared with the control group, the overall response rate (ORR) [complete remission (CR)+partial remission (PR) + hematologic improvement (HI) rate] of the decitabine+CAG group was higher (83.3% vs 62.5%)(P=0.043), and the AEs were not significantly increased. Cytopenia grade ≥3 and infection after treatment were the most prevalent AEs, which occurred in the early stage (within the first 2 cycles) and gradually decreased later. Other non-hematologic AEs were infrequent.

CONCLUSION

Low-dose decitabine combined with CAG regimen has better clinical efficacy for patients with MDS-RAEB than that of decitabine alone. It is worthy to be applied in clinic, especially for these patients who are not ineligible for hematopoietic stem cell transplantation.

摘要

目的

通过回顾性分析,探讨小剂量地西他滨联合CAG方案治疗骨髓增生异常综合征伴原始细胞增多难治性贫血(MDS-RAEB)患者的临床疗效。

方法

选取36例曾接受小剂量地西他滨联合CAG方案治疗的MDS-RAEB患者作为地西他滨+CAG组,另选取40例在本中心接受单纯地西他滨治疗的MDS-RAEB患者作为对照组。比较两组患者的临床特征、疗效及不良反应(AE)。

结果

与对照组相比,地西他滨+CAG组的总缓解率(ORR)[完全缓解(CR)+部分缓解(PR)+血液学改善(HI)率]更高(83.3%对62.5%)(P=0.043),且不良反应未显著增加。治疗后血细胞减少≥3级和感染是最常见的不良反应,多发生在早期(前2个周期内),随后逐渐减少。其他非血液学不良反应较少见。

结论

小剂量地西他滨联合CAG方案治疗MDS-RAEB患者的临床疗效优于单纯地西他滨。值得临床应用,尤其是对于那些不适合进行造血干细胞移植的患者。

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