Hou Li-Min, Gao Ying, Gao Qiu-Ying, Niu Ben
Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China.
Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Jun;32(3):679-684. doi: 10.19746/j.cnki.issn.1009-2137.2024.03.005.
To investigate the efficacy of decitabine combined with preexcitation regimen in the treatment of newly diagnosed acute myeloid leukemia (AML) patients who have not been relieved by the first standard induction chemotherapy and its influence on the relative content of regulatory T lymphocytes (Tregs).
The clinical data of 102 newly diagnosed AML patients (except acute promyelocytic leukemia) who did not relieve after initial standard induction chemotherapy in Shaanxi Provincial People's Hospital from March 2013 to March 2019 were retrospectively analyzed. Fifty-one patients who accepted pre-excitation regimen were divided into regular group, while another 51 patients treated with decitabine combined with pre-excitation regimen were divided into combination group. The efficacy, incidence of toxic and side effects, Core Scale of Quality of Life (QLQ-C30) score before and after treatment, T lymphocyte subsets (CD3, CD4, CD4/CD8, Tregs) and 3-year overall survival (OS) rate were compared between the two groups.
The total effective rate of combination group was 80.39%, which was significantly higher than 62.75% of regular group ( < 0.05). After treatment, the QLQ-C30 score of combination group was 60.27±6.96, which was significantly lower than 65.73±7.96 of regular group ( < 0.001). There was no statistical difference in the incidence of toxic and side effects between the two groups ( >0.05). After treatment, the levels of CD3, CD4, CD4/CD8 in the combination group were higher than those in the regular group (all < 0.001), while Treg was lower ( < 0.001). The 3-year OS rate in the combination group was 72.55%, which was significantly higher than 52.94% in the regular group ( < 0.001).
Decitabine combined with preexcitation regimen has a significant effect on AML patients who have not been alleviated by standard induction chemotherapy in the first course of treatment. It can reduce anti-tumor immune suppression and improve immune function by regulating the relative content of Tregs, thus prolongs survival time and improves life quality of patients without increasing adverse reactions.
探讨地西他滨联合预激方案治疗初诊标准诱导化疗未缓解的急性髓系白血病（AML）患者的疗效及其对调节性T淋巴细胞（Tregs）相对含量的影响。
回顾性分析2013年3月至2019年3月在陕西省人民医院初诊标准诱导化疗未缓解的102例AML患者（急性早幼粒细胞白血病除外）的临床资料。将接受预激方案的51例患者分为常规组，另51例接受地西他滨联合预激方案治疗的患者分为联合组。比较两组的疗效、毒副作用发生率、治疗前后生活质量核心量表（QLQ-C30）评分、T淋巴细胞亚群（CD3、CD4、CD4/CD8、Tregs）及3年总生存率（OS）。
联合组总有效率为80.39%，显著高于常规组的62.75%（P<0.05）。治疗后，联合组QLQ-C30评分为60.27±6.96，显著低于常规组的65.73±7.96（P<0.001）。两组毒副作用发生率差异无统计学意义（P>0.05）。治疗后，联合组CD3、CD4、CD4/CD8水平高于常规组（均P<0.001），而Treg水平低于常规组（P<0.001）。联合组3年OS率为72.55%，显著高于常规组的52.94%（P<0.001）。
地西他滨联合预激方案对初治标准诱导化疗未缓解的AML患者有显著疗效。通过调节Tregs相对含量，可减轻抗肿瘤免疫抑制，改善免疫功能，从而延长患者生存时间，提高生活质量，且不增加不良反应。
