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含砷青黄散()是一种替代疗法,用于拒绝低强度化疗的老年急性髓系白血病患者。

Arsenic-Containing Qinghuang Powder () is an Alternative Treatment for Elderly Acute Myeloid Leukemia Patients Refusing Low-Intensity Chemotherapy.

机构信息

Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.

Graduate School, China Academy of Chinese Medical Sciences, Beijing, 100700, China.

出版信息

Chin J Integr Med. 2020 May;26(5):339-344. doi: 10.1007/s11655-019-3050-6. Epub 2019 Dec 17.

Abstract

OBJECTIVE

To analyze the overall survival (OS) of elderly acute myeloid leukemia (AML) patients treated with oral arsenic-containing Qinghuang Powder (, QHP) or low-intensity chemotherapy (LIC).

METHODS

Forty-two elderly AML patients treated with intravenous or subcutaneous LIC (1 month for each course, at least 3 courses) or oral QHP (3 months for each course, at least 2 courses) were retrospectively analyzed from January 2015 to December 2017. The main endpoints of analysis were OS and 1-, 2-, 3-year OS rates of patients, respectively. And the adverse reactions induding bone marrow suppression, digestive tract discomfort and myocardia injury were observed.

RESULTS

Out of 42 elderly AML patients, 22 received LIC treatment and 20 received QHP treatment, according to patients' preference. There was no significant difference on OS between LIC and QHP patients (13.0 months vs. 13.5 months, >0.05). There was no significant difference on OS rates between LIC and QHP groups at 1 year (59.1% vs. 70.0%), 2 years (13.6% vs. 15%), and 3 years (4.6% vs. 5.0%, all >0.05). Furthermore, there was no significant difference of OS on prognosis stratification of performance status > 2 (12 months vs. 12 months), age> 75 year-old (12.0 months vs. 12.5 months), hematopoietic stem cell transplant comorbidity index >2 (12 months vs. 13 months), poor cytogenetics (12 months vs. 8 months), and diagnosis of secondary AML (10 months vs. 14 months) between LIC and QHP patients (>0.05).

CONCLUSION

QHP may be an alternative treatment for elderly AML patients refusing LIC therapy.

摘要

目的

分析接受口服含砷青黄散(QHP)或低强度化疗(LIC)治疗的老年急性髓系白血病(AML)患者的总生存期(OS)。

方法

回顾性分析 2015 年 1 月至 2017 年 12 月接受静脉或皮下 LIC(每疗程 1 个月,至少 3 个疗程)或口服 QHP(每疗程 3 个月,至少 2 个疗程)治疗的 42 例老年 AML 患者。分析的主要终点分别为患者的 OS 和 1、2、3 年 OS 率。观察不良反应包括骨髓抑制、消化道不适和心肌损伤。

结果

根据患者的意愿,42 例老年 AML 患者中 22 例接受 LIC 治疗,20 例接受 QHP 治疗。LIC 和 QHP 患者的 OS 无显著差异(13.0 个月比 13.5 个月,>0.05)。LIC 和 QHP 组 1 年(59.1%比 70.0%)、2 年(13.6%比 15%)和 3 年(4.6%比 5.0%)的 OS 率无显著差异(均>0.05)。此外,在体能状态>2(12 个月比 12 个月)、年龄>75 岁(12.0 个月比 12.5 个月)、造血干细胞移植合并症指数>2(12 个月比 13 个月)、不良细胞遗传学(12 个月比 8 个月)和诊断为继发性 AML(10 个月比 14 个月)的预后分层中,LIC 和 QHP 患者的 OS 也无显著差异(均>0.05)。

结论

QHP 可能是拒绝 LIC 治疗的老年 AML 患者的另一种治疗选择。

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