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两种化疗方案治疗骨髓增生异常综合征-难治性贫血伴原始细胞过多/急性髓系白血病伴骨髓增生异常相关改变患者的临床比较

[Clinical Comparation of Two Kinds of Chemotherapy Regimens in the Treatment of Patients with MDS-RAEB/AML-MRC].

作者信息

Wu Xi-Feng, Li Tan-Tan, Sun Ling, Wang Li-Juan, Ran Xue-Hong

机构信息

Department of Hematology, Jinan Municipal People's Hospital, Jinan 271100, Shandong Province, China.

Department of Hematology, Weifang Municipal People's Hospital, Weifang 261042, Shandong Province, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Jun;28(3):894-898. doi: 10.19746/j.cnki.issn.1009-2137.2020.03.029.

Abstract

OBJECTIVE

To investigate the influence of conventional CAG regimen and decitabine + decreased dose CAG (D+dCAG) regimen on the clinical efficacy and safety of patients with MDS-RAEB/AML-MRC.

METHODS

The clinical data of 67 patients with MDS-RAEB/AML-MRC hospitalized in our hospital from March 2012 to July 2017 were analyzed retrospectively. According to chemotherapecctic regimens, 76 patients were divided into 2 groups: 37 patients treated with conventional CAG regimen were enrolled in control group, 30 patients treated with decitabine + decreased dose CAG regimen were enrolled in D+dCAG group. The complete remission (CR) rate, overall remission rate (ORR), OS and PFS time and incidence of adverse reactions in 2 groups were compared.

RESULTS

The CR in D+dCAG group was significantly higher than that in control group (P<0.05). ORR was not significanly different between 2 groups (P>0.05). There was no significant difference in the cumulative OS rate between 2 groups (P>0.05). There was no significant difference in the cumulative OS rate and PFS rate in nonimplantation between 2 groups (P>0.05). The incidence of adverse reactions of hematological system, pulmonary infection, skin and soft tissue infection, agranulocytosic fever and mycotic infection was not significanly different between 2 groups (P>0.05). The duration of granulocyte deficiency and platelet count less than 20×10/L were not significanly different between 2 groups (P>0.05).

CONCLUSION

Compared with conventional CAG regimen, decitabine + decreased dose CAG regimen in the treatment of patients with MDS-RAEB/AML-MRC can efficiently improve the remission effects and showed the well overall safety, but can not increase the survival rate.

摘要

目的

探讨传统CAG方案与地西他滨+减低剂量CAG(D+dCAG)方案对骨髓增生异常综合征伴原始细胞过多难治性贫血/急性髓系白血病伴骨髓增生异常相关改变(MDS-RAEB/AML-MRC)患者临床疗效及安全性的影响。

方法

回顾性分析2012年3月至2017年7月在我院住院治疗的67例MDS-RAEB/AML-MRC患者的临床资料。根据化疗方案将76例患者分为2组:对照组37例采用传统CAG方案治疗,D+dCAG组30例采用地西他滨+减低剂量CAG方案治疗。比较两组的完全缓解(CR)率、总缓解率(ORR)、总生存期(OS)和无进展生存期(PFS)以及不良反应发生率。

结果

D+dCAG组的CR率显著高于对照组(P<0.05)。两组的ORR差异无统计学意义(P>0.05)。两组的累积OS率差异无统计学意义(P>0.05)。两组未植入患者的累积OS率和PFS率差异无统计学意义(P>0.05)。两组血液系统不良反应、肺部感染、皮肤及软组织感染、粒细胞缺乏性发热和真菌感染的发生率差异无统计学意义(P>0.05)。两组粒细胞缺乏持续时间及血小板计数低于20×10⁹/L的情况差异无统计学意义(P>0.05)。

结论

与传统CAG方案相比,地西他滨+减低剂量CAG方案治疗MDS-RAEB/AML-MRC患者可有效提高缓解效果,总体安全性良好,但不能提高生存率。

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