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地西他滨联合 G-CSF、小剂量阿糖胞苷和阿克拉霉素与标准剂量化疗在新诊断的 55 至 69 岁急性髓细胞白血病患者诱导治疗中同样有效。

Decitabine in combination with G-CSF, low-dose cytarabine and aclarubicin is as effective as standard dose chemotherapy in the induction treatment for patients aged from 55 to 69 years old with newly diagnosed acute myeloid leukemia.

机构信息

a Department of Hematology , The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital , Key Laboratory of Hematology , Nanjing Medical University , Nanjing , China.

b Department of Oncology , The Second Affiliated Hospital of Southeast University , Nanjing , China.

出版信息

Leuk Lymphoma. 2018 Nov;59(11):2570-2579. doi: 10.1080/10428194.2018.1443328. Epub 2018 Apr 4.

Abstract

We retrospectively studied 87 patients aged from 55 to 69 years old with acute myeloid leukemia (AML) who received decitabine in combination with G-CSF, low-dose cytarabine and aclarubicin (DCAG) or standard dose chemotherapy as induction therapy. Patients receiving DCAG had a similar overall response rate (ORR) ( = .6105) and complete remission (CR) rate ( = .3615) compared to those undergoing standard induction. The median overall survival (OS) and relapse-free survival (RFS) was also similar between the two groups although more 'older' (aged from 60 to 69 years old) and 'unfit' patients underwent DCAG regimen. Notably, patients in DCAG group experienced significantly fewer infections (75 versus 100%,  = .001). Moreover recovery of platelet count was significantly more rapid in DCAG group. Thus we speculate DCAG is possibly a feasible and safe treatment regimen for the relatively older patients with AML and is as effective as standard induction.

摘要

我们回顾性研究了 87 例年龄在 55 至 69 岁的急性髓系白血病(AML)患者,他们接受地西他滨联合 G-CSF、低剂量阿糖胞苷和阿克拉霉素(DCAG)或标准剂量化疗作为诱导治疗。与接受标准诱导治疗的患者相比,接受 DCAG 治疗的患者总体缓解率(ORR)( = .6105)和完全缓解率(CR)( = .3615)相似。虽然接受 DCAG 方案的患者中有更多的“老年”(年龄 60 至 69 岁)和“不适合”的患者,但两组的中位总生存期(OS)和无复发生存期(RFS)相似。值得注意的是,DCAG 组患者感染的发生率明显更低(75%比 100%, = .001)。此外,DCAG 组血小板计数的恢复明显更快。因此,我们推测 DCAG 可能是一种可行且安全的治疗方案,适用于年龄较大的 AML 患者,与标准诱导治疗同样有效。

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