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越南骨髓增生异常肿瘤确诊患者的治疗:发展中国家的实践经验

Treatment of Vietnamese patients diagnosed with myelodysplastic neoplasms: Practical experience in a developing country.

作者信息

Nguyen Quang Hao, Vu Minh Phuong, Kieu Ha Trang, Vu Duc Binh, Nguyen Ha Thanh, Bach Quoc Khanh

机构信息

Hematology Clinical Department, Thai Nguyen National Hospital, Thainguyen Province 24124, Vietnam.

Department of Hematology, Hanoi Medical University, Hanoi 11521, Vietnam.

出版信息

Leuk Res Rep. 2024 Nov 24;23:100490. doi: 10.1016/j.lrr.2024.100490. eCollection 2025.

Abstract

BACKGROUND

Treatment of patients diagnosed with myelodysplastic neoplasms (MDS) is difficult and the outcome is still limited, especially in developing countries. We conducted this study in order to share some experience in treating patients diagnosed with MDS in developing countries.

METHODS

This was a retrospective study that included 32 patients with newly MDS. 13 lower-risk patients, including 2 patients with MDS 5q- were treated with erythropoiesis stimulating agent (ESA). 19 patients with higher risk were treated with hypomethylating agent (HMA), which was decitabine.

RESULTS

In the ESA treatment group, the rate of hematologic improvement-erythroid was 69.2 %, the rate of total hematologic improvement (with 3 lineages improvement) was 61.5 %. In the HMA treatment group, the overall response rate was 52.6 %. The follow-up times were 42 months. The overall survival (OS), leukemic transformation-free survival (LFS), and progression-free survival (PFS) of the ESA treatment group were 30.44, 28.91, and 28.29 months; respectively. The OS, LFS, and PFS of the HMA treatment group were 34.27, 31.45, and 26.83 months; respectively

CONCLUSIONS

Patients with lower risk MDS, including MDS 5q-, may benefit from treatment with erythropoiesis stimulating agent (ESA). Patients with higher risk MDS may have a favorable outcome with decitabine (HMA) treatment.

摘要

背景

诊断为骨髓增生异常肿瘤(MDS)的患者治疗困难,且治疗效果仍然有限,尤其是在发展中国家。我们开展这项研究是为了分享在发展中国家治疗诊断为MDS患者的一些经验。

方法

这是一项回顾性研究,纳入32例新诊断的MDS患者。13例低危患者,包括2例5q-综合征MDS患者,接受促红细胞生成素(ESA)治疗。19例高危患者接受去甲基化药物(HMA)地西他滨治疗。

结果

在ESA治疗组中,血液学改善(红系)率为69.2%,总血液学改善率(三系改善)为61.5%。在HMA治疗组中,总体缓解率为52.6%。随访时间为42个月。ESA治疗组的总生存期(OS)、无白血病转化生存期(LFS)和无进展生存期(PFS)分别为30.44、28.91和28.29个月;HMA治疗组的OS、LFS和PFS分别为34.27、31.45和26.83个月。

结论

低危MDS患者,包括5q-综合征MDS患者,可能从促红细胞生成素(ESA)治疗中获益。高危MDS患者接受地西他滨(HMA)治疗可能有良好预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7ea/11648795/487e64d9397b/gr1.jpg

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