Wataya S, Sudou H, Sakamaki I, Wano Y, Ueda T, Nakamura T
First Department of Medicine, Fukui Medical School.
Nihon Ronen Igakkai Zasshi. 1995 Jun;32(6):438-41. doi: 10.3143/geriatrics.32.438.
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic disorders characterized by normal or hypercellular but dysfunctional bone marrow. They usually are refractory to empirical therapeutic regimens. Recently the prevalence of MDS in the elderly is increasing and now the syndromes are relatively commonly encountered in elderly patients. Two major causes of death in MDS are progression to acute leukemia (especially in subtypes of RAEB and RAEB in T), and bone marrow aplasia. Since cytoreductive therapy for RAEB or RAEB in T in the elderly is often accompanied by serious adverse complications, such as infection and hemorrhage, special care is necessary. Here we describe successful induction remission in a 74-year-old man with MDS (RAEB in T) by twice daily low-dose cytosine arabinoside injections (10 mg/m2, s.c.), which was well-tolerated, free of serious adverse effects, and seemed to be a useful therapeutic option for elderly patient with RAEB or RAEB in T.
骨髓增生异常综合征（MDS）是一组异质性的克隆性造血疾病，其特征是骨髓正常或细胞增多但功能异常。它们通常对经验性治疗方案无效。近年来，老年人中MDS的患病率不断上升，目前该综合征在老年患者中相对常见。MDS的两个主要死亡原因是进展为急性白血病（尤其是RAEB和RAEB - T亚型）以及骨髓再生障碍。由于老年患者中RAEB或RAEB - T的细胞减灭治疗常伴有严重的不良并发症，如感染和出血，因此需要特别护理。在此，我们描述了一名74岁MDS（RAEB - T）男性患者通过每日两次皮下注射低剂量阿糖胞苷（10 mg/m²）成功诱导缓解的病例，该治疗耐受性良好，无严重不良反应，似乎是老年RAEB或RAEB - T患者的一种有效治疗选择。
