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西达本胺和地西他滨联合 HAG 预激方案治疗伴有 TP53 基因突变的急性髓系白血病。

Chidamide and Decitabine in Combination with a HAG Priming Regimen for Acute Myeloid Leukemia with TP53 Mutation.

机构信息

Department of Hematology, Jiaozuo People's Hospital.

出版信息

Acta Med Okayama. 2022 Feb;76(1):63-70. doi: 10.18926/AMO/63213.

Abstract

We analyzed the treatment effects of chidamide and decitabine in combination with a HAG (homoharringtonine, cytarabine, G-CSF) priming regimen (CDHAG) in acute myeloid leukemia (AML) patients with TP53 mutation. Seven TP53 mutated AML patients were treated with CDHAG. The treatment effects were assessed using hemogram detection and bone marrow aspirate. The possible side effects were evaluated based on both hematological and non-hematological toxicity. Four of the seven patients were classified as having achieved complete remission after CDHAG treatment; one patient was considered to have achieved partial remission, and the remaining two patients were considered in non-remission. The overall response rate (ORR) to CDHAG was 71.4%. Regarding the side effects, the hematological toxicity level of the seven patients ranged from level III to level IV, and infections that occurred at lung, blood, and skin were recorded. Nausea, vomiting, liver injury, and kidney injury were also detected. However, all side effects were attenuated by proper management. The CDHAG regimen clearly improved the ORR (71.4%) of TP53-mutated AML patients, with no severe side effects.

摘要

我们分析了在伴有 HAG(高三尖杉酯碱、阿糖胞苷、G-CSF)预激方案的情况下,西达本胺联合地西他滨治疗伴有 TP53 突变的急性髓系白血病(AML)患者的治疗效果。7 例 TP53 突变的 AML 患者接受了 CDHAG 治疗。采用血象检测和骨髓抽吸评估治疗效果。根据血液学和非血液学毒性评估可能的副作用。CDHAG 治疗后,4 例患者被归类为完全缓解;1 例患者被认为部分缓解,其余 2 例患者未缓解。CDHAG 的总体缓解率(ORR)为 71.4%。关于副作用,7 例患者的血液学毒性水平为 3 级至 4 级,并记录了肺部、血液和皮肤感染。还检测到恶心、呕吐、肝损伤和肾损伤。然而,所有的副作用都通过适当的治疗得到了缓解。CDHAG 方案明显提高了伴有 TP53 突变的 AML 患者的 ORR(71.4%),且无严重副作用。

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