地西他滨联合小剂量IA方案治疗骨髓增生异常综合征伴原始细胞增多的临床观察

发布时间：2018-04-21 20:23

本文选题：地西他滨 + 骨髓增生异常综合征　；参考：《中国实验血液学杂志》2017年05期

【摘要】：目的:观察地西他滨联合小剂量去甲氧柔红霉素、阿糖胞苷(DAC+IA)方案治疗骨髓增生异常综合征伴原始细胞增多的临床疗效。方法:回顾性分析2015年6月-2017年1月在西安交通大学第一附属医院血液科治疗的37例骨髓增生异常综合征伴原始细胞增多患者,分别采用DAC+IA方案(19例)和单用DAC(18例)方案治疗,观察其临床疗效和不良反应。结果:1-2疗程后,DAC+IA组CR+CRi率为57.9%,总反应率100%,骨髓病理组织幼稚细胞明显减少,外周血中性粒细胞、血红蛋白、血小板水平显著提高,完全缓解中位持续时间7.3月,无进展生存时间为10月,3例患者缓解后停止治疗,3.5月复发。DAC组CR+CRi率为16.7%,总反应率38.9%,中位无进展生存时间为6月。3例患者达到完全缓解,中位时间4个月均进展为AML。两组患者常见的不良反应为骨髓抑制和感染,其差异无统计学意义。结论:DAC联合小剂量IA方案治疗骨髓增生异常综合征伴原始细胞增多,可延长患者生存期,改善生存质量,近期疗效显著,但远期疗效仍有待于异基因造血干细胞移植进行巩固。
[Abstract]:Aim: to observe the clinical effect of combination of dicitabine and low dose normodaunorubicin, cytosine arabinoside DAC IAA regimen in the treatment of myelodysplastic syndrome (MDS) with proliferation of primitive cells. Methods: a retrospective analysis of 37 patients with myelodysplastic syndrome (MDS) associated with primitive cell proliferation was performed in the Department of Hematology, first affiliated Hospital of Xi'an Jiaotong University from June 2015 to January 2017. DAC IA regimen (n = 19) and DAC(18 regimen (n = 19) were used to observe the clinical efficacy and adverse reactions. Results the CR CRi rate was 57.9, the total response rate was 100%, the neutrophils, hemoglobin and platelet levels in the bone marrow tissue decreased significantly, and the median remission duration was 7.3 months after one or two courses of treatment. No progression survival time was achieved in 3 patients after remission in October, CR CRi rate was 16.7in 3.5 months recurrence group, total response rate was 38.9, median progression-free survival time was 6 months, complete remission was achieved in 3 patients, and the median time was 4 months. The common adverse reactions of the two groups were bone marrow suppression and infection, the difference was not statistically significant. Conclusion the treatment of myelodysplastic syndromes combined with small dose IA regimen can prolong the survival time and improve the quality of life in patients with myelodysplastic syndromes. The short-term curative effect is remarkable, but the long-term effect still needs to be consolidated by allogeneic hematopoietic stem cell transplantation.
【作者单位】：西安交通大学第一附属医院血液内科;
【分类号】：R551.3

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