二甲双胍联合化疗对急性淋巴细胞白血病患者生存的影响
[Effect of metformin added to chemotherapy on the survival of patients with acute lymphoblastic leukemia].
作者信息
Ramos Peñafiel Christian, Olarte Carrillo Irma, Ceron Maldonado Rafael, Miranda Peralta Enrique, Rozen Fuller Etta, Kassack Ipiña Juan Julio, Centeno Cruz Federico, Collazo Jaloma Juan, Martínez Tovar Adolfo
机构信息
Servicio de Hematología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
出版信息
Rev Med Chil. 2018 Jul;146(7):846-853. doi: 10.4067/s0034-98872018000700846.
BACKGROUND
Metformin has antineoplastic and cancer protective effects in vitro, sensitizing leukemia cells to chemotherapeutic agents, inducing apoptosis and cell cycle arrest.
AIM
To assess the effect of metformin on the induction stage in patients with ALL and its impact on overall survival and relapse.
MATERIAL AND METHODS
We included 123 patients treated with metformin and without metformin. The dose used was 850 mg PO at 8 h intervals. The survival analysis was used by Kaplan-Meier method, the difference between the distinct groups was performed using the log Rank test.
RESULTS
The overall survival at a median follow up of 700 days of follow-up was 43%, with a disease-free survival of 47%. Regarding the treatment groups, patients with metformin had a lower rate of relapse compared to the group receiving only chemotherapy (6.5% vs 17.1%, p = 0.006).
CONCLUSIONS
The addition of metformin to the conventional treatment of ALL was associated with an improvement in survival, this association being independent of the type of biological risk at diagnosis.
背景
二甲双胍在体外具有抗肿瘤和癌症保护作用，可使白血病细胞对化疗药物敏感，诱导细胞凋亡和细胞周期停滞。
目的
评估二甲双胍对急性淋巴细胞白血病（ALL）患者诱导期的影响及其对总生存期和复发的影响。
材料与方法
我们纳入了123例接受二甲双胍治疗和未接受二甲双胍治疗的患者。使用的剂量为850毫克口服，每8小时一次。采用Kaplan-Meier法进行生存分析，使用对数秩检验比较不同组之间的差异。
结果
在中位随访700天的情况下，总生存率为43%，无病生存率为47%。关于治疗组，与仅接受化疗的组相比，接受二甲双胍治疗的患者复发率较低（6.5%对17.1%，p = 0.006）。
结论
在ALL的常规治疗中添加二甲双胍与生存率的提高相关，这种关联与诊断时的生物学风险类型无关。
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