低剂量地西他滨对老年骨髓增生异常综合征患者可溶性CD44、生长分化因子11水平及造血功能的影响
[Effects of Low-Dose Decitabine on Soluble CD44, GDF11 Levels and Hematopoietic Function in Elderly Patients with MDS].
作者信息
Guo Su-Qing, Shi Rui, Chen Yuan-Yuan, Liu Shan, Li Ying-Hua
机构信息
Department of Hematology, Hengshui Harrison International Peace Hospital, Hengshui 053000, Hebei Province, China.
Department of Hematology, Hengshui Harrison International Peace Hospital, Hengshui 053000, Hebei Province, China,E-mail:
出版信息
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Apr;27(2):509-514. doi: 10.19746/j.cnki.issn.1009-2137.2019.02.032.
OBJECTIVE
To investigate the effects of low-dose decitabine on levels of soluble CD44 and GDF11, and hematopoietic function in elderly patients with myelodysplastic syndrome (MDS).
METHODS
Ninety-nine patients with senile myelodysplastic syndrome (MDS) admitted to our hospital from October 2015 to October 2017 were divided into group A, B and C according to their treatment, each with 33 cases.The patients in group A were treated with low-dose decitabine, the patients in group B were treated with usual dose of decitabine, and the patients in group C were treated with low-dose decitabine plus G-GSF, cytarabine, and aclarithromycin. The changes of soluble CD44, GDF11 levels and hematopoietic function (sTfR/E) were compared before and after treatment. The clinical remission rate and adverse reaction rate in 3 groups were analyzed.
RESULTS
Before treatment, the levels of CD44, GDF11 and sTfR/E were not significantly different between the 3 groups (P＞0.05). After treatment, the levels of CD44 and GDF11 were significantly decreased in these groups, while the serum levels of sTfR/E were significantly increased, and there was no significant difference between the 3 groups (P＞0.05). After treatment, the total effective rates of A, B, and C 3 group were 82.3%, 81.8%, and 78.8%, respectively, without statistically significant difference (P＞0.05). During the treatment, the incidence of non-hemotoxic adverse reactions in group A was 8.8%, significantly lower than that in group B and C (30.3%, 27.3%) (P＜0.05, P＜0.05), the incidence of hemotoxic adverse reactions in group A was 39.4%, significantly lower than that 63.6% and 66.7% in group B and C (P＜0.05, P＜0.05).
CONCLUSION
Low-dose decitabine alone is effective in treating elderly patients with MDS as compared with conventional dose and combination therapy, moreover can significantly reduce the levels of CD44 and GDF11, improve hematopoietic function and low the adverse reactions. Thereby the low dose of decitabine may be a new choice for clinical treatment of MDS.
目的
探讨低剂量地西他滨对老年骨髓增生异常综合征（MDS）患者可溶性CD44、生长分化因子11（GDF11）水平及造血功能的影响。
方法
选取2015年10月至2017年10月我院收治的99例老年骨髓增生异常综合征患者，根据治疗方法分为A、B、C组，每组33例。A组患者采用低剂量地西他滨治疗，B组患者采用常规剂量地西他滨治疗，C组患者采用低剂量地西他滨联合粒细胞集落刺激因子（G-GSF）、阿糖胞苷及克拉霉素治疗。比较治疗前后可溶性CD44、GDF11水平及造血功能（血清转铁蛋白受体/红细胞比值，sTfR/E）的变化。分析3组患者的临床缓解率及不良反应发生率。
结果
治疗前，3组患者CD44、GDF11及sTfR/E水平比较，差异无统计学意义（P＞0.05）。治疗后，3组患者CD44、GDF11水平均显著降低，血清sTfR/E水平均显著升高，3组间比较，差异无统计学意义（P＞0.05）。治疗后，A、B、C 3组总有效率分别为82.3%、81.8%、78.8%，差异无统计学意义（P＞0.05）。治疗期间，A组非血液学不良反应发生率为8.8%，显著低于B组和C组（30.3%、27.3%）（P＜0.05，P＜0.05）；A组血液学不良反应发生率为39.4%，显著低于B组和C组的63.6%及66.7%（P＜0.05，P＜0.05）。
结论
与常规剂量及联合治疗相比，单独使用低剂量地西他滨治疗老年MDS患者有效，且可显著降低CD44、GDF11水平，改善造血功能，降低不良反应。因此，低剂量地西他滨可能成为MDS临床治疗的新选择。
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