低剂量地西他滨序贯CAG方案治疗MDS-难治性贫血伴有原始细胞过多的临床疗效

发布时间：2018-06-17 05:40

本文选题：地西他滨 + CAG方案　；参考：《中国实验血液学杂志》2017年05期

【摘要】：目的:通过回顾性分析探讨低剂量地西他滨序贯CAG方案治疗骨髓增生异常综合征-难治性贫血伴有原始细胞过多(MDS-RAEB)的临床疗效。方法:将我院收治的接受低剂量地西他滨序贯CAG方案治疗的36例MDSRAEB患者,纳入地西他滨序贯CAG组;同期将单用地西他滨治疗的M DS-RAEB 40例患者作为对照,比较2组患者临床特征、疗效及不良反应等。结果:序贯CAG组总有效率(ORR)[完全缓解(CR)+部分缓解(PR)+血液学改善(HI)]为83.3%(30/36),明显高于单用地西他滨ORR 62.5%(25/40)(P=0.043),2组不良反应比较无显著差别。地西他滨序贯CAG组最常见的不良反应为3度以上的血细胞减少和感染,在治疗早期(第1-2疗程)比较常见,治疗有效后上述不良反应逐渐减少,其他非血液学不良反应少见。结论:地西他滨序贯CAG方案治疗MDS-RAEB比单用地西他滨疗效更确切,此方案对不适合行造血干细胞移植的患者可能有重要的临床价值。
[Abstract]:Objective: To explore the clinical effect of low dose of the sequential CAG regimen for the treatment of myelodysplastic syndrome, refractory anemia and primitive cell overabundance (MDS-RAEB) by retrospective analysis. Methods: 36 cases of MDSRAEB patients treated in our hospital were treated with low dose of West itabine sequential CAG regimen and included in the sequential CAG group. 40 patients with M DS-RAEB treated with single use of Western itabine as control were compared. The clinical features, efficacy and adverse reactions of the 2 groups were compared. Results: the total effective rate of the sequential CAG group (ORR) [complete remission (CR) + partial remission (PR) + hematological improvement (HI)] was 83.3% (30/36), obviously higher than the ORR 62.5% (25/40) (P=0.043) of single use, 2 groups of adverse reactions. There is no significant difference. The most common adverse reaction in the CAG group is more than 3 degrees of hemocyte reduction and infection. In the early treatment (the 1-2 course of treatment), the most common adverse reaction is more common. After the treatment is effective, the aforesaid adverse reactions are gradually reduced and other non hematological adverse reactions are rare. Conclusion: the sequential CAG regimen of the sahitabine is used for the treatment of MDS-RAEB than the single use land. The efficacy of citabine is more accurate. This scheme may have important clinical value for patients who are not suitable for hematopoietic stem cell transplantation.
【作者单位】：郑州大学第一附属医院血液科;
【基金】：国家自然科学基金(U1504806) 河南省医学科技攻关计划项目(201403029)
【分类号】：R551.3;R556

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