超小剂量地西他滨治疗骨髓增生异常综合征37例疗效及安全性评价
发布时间：2018-08-30 12:50
【摘要】：目的探讨超小剂量地西他滨方案治疗骨髓增生异常综合征(MDS)的临床疗效及安全性。方法收集2014年1月至2015年10月江苏省人民医院血液科收治接受地西他滨治疗可评价的MDS患者37例。皮下注射地西他滨(每日5~7 mg/m2,治疗第1~3天,第8、15、22天),每4周为1个疗程,连续4~6个疗程。比较不同预后分组间疗效差异,评价可能与疗效相关的参数。结果 20例(54%)获得了临床反应,其中2例(5.4%)完全缓解,骨髓完全缓解无血液学改善1例(2.7%),骨髓完全缓解伴血液学改善1例(2.7%),血液学改善14例(37.8%),脱离输血2例(5.4%);疾病稳定14例(37.8%),疾病进展3例(8.1%)。按WPSS预后分层分组,较低危组与较高危组之间总反应率差异有统计学意义(70.0%对35.3%,χ~2=4.457,P=0.035);按IPSS-R细胞遗传学分层,预后良好组与中危组、高危组之间总反应率差异有统计学意义(60%对25%,χ~2=6.036,P=0.014);根据查尔森合并症指数(CCI)分组,各组间疗效差异无统计学意义。Ⅲ~Ⅳ度骨髓抑制13例(35.1%);在粒细胞缺乏期9例(24.3%)(Ⅱ~Ⅳ度)发生感染性发热;没有因血液学毒性而死亡;未观察到Ⅲ~Ⅳ级胃肠道及心、肝、肾等毒副反应。骨髓抑制、发热等不良反应根据CCI危险分层比较,低危、中危及高危之间不良反应发生率差异无统计学意义(P0.05)。结论超小剂量地西他滨方案治疗MDS疗效佳,且耐受性良好,低、中危组MDS疗效好于高危组。有合并症不影响疗效。
[Abstract]:Objective to evaluate the efficacy and safety of low dose dietabine regimen in the treatment of myelodysplastic syndrome (MDS). Methods from January 2014 to October 2015, 37 patients with MDS treated with desitabine in hematology department of Jiangsu Provincial people's Hospital were collected. Dietabine was subcutaneously injected (5: 7 mg/m2, per day, day 1: 3, day 8, 15, 22), every 4 weeks as a course of treatment for 4 ~ 6 consecutive courses. To compare the difference of curative effect among groups with different prognosis, and to evaluate the parameters that may be related to curative effect. Results Clinical reactions were obtained in 20 cases (54%), of which 2 cases (5.4%) had complete remission. There was no hematological improvement in 1 case (2.7%), hematological improvement in 14 cases (37.8%), blood transfusion in 2 cases (5.4%), stable disease in 14 cases (37.8%), disease progression in 3 cases (8.1%). According to WPSS prognostic stratification, there was significant difference in the total response rate between the lower risk group and the higher risk group (70.0% vs 35.33%, 蠂 2 4.457 P0. 035), and according to the IPSS-R cytogenetic stratification, the prognosis was better in the group with good prognosis than that in the group of the middle risk group. There was significant difference in total response rate between high risk groups (60% vs 25%, 蠂 2 + 6.036% P0. 014). According to the Charlson complication index (CCI), there was no significant difference in the total response rate between the two groups. 13 cases (35.1%) of grade 鈪，
本文编号：2213119
[Abstract]:Objective to evaluate the efficacy and safety of low dose dietabine regimen in the treatment of myelodysplastic syndrome (MDS). Methods from January 2014 to October 2015, 37 patients with MDS treated with desitabine in hematology department of Jiangsu Provincial people's Hospital were collected. Dietabine was subcutaneously injected (5: 7 mg/m2, per day, day 1: 3, day 8, 15, 22), every 4 weeks as a course of treatment for 4 ~ 6 consecutive courses. To compare the difference of curative effect among groups with different prognosis, and to evaluate the parameters that may be related to curative effect. Results Clinical reactions were obtained in 20 cases (54%), of which 2 cases (5.4%) had complete remission. There was no hematological improvement in 1 case (2.7%), hematological improvement in 14 cases (37.8%), blood transfusion in 2 cases (5.4%), stable disease in 14 cases (37.8%), disease progression in 3 cases (8.1%). According to WPSS prognostic stratification, there was significant difference in the total response rate between the lower risk group and the higher risk group (70.0% vs 35.33%, 蠂 2 4.457 P0. 035), and according to the IPSS-R cytogenetic stratification, the prognosis was better in the group with good prognosis than that in the group of the middle risk group. There was significant difference in total response rate between high risk groups (60% vs 25%, 蠂 2 + 6.036% P0. 014). According to the Charlson complication index (CCI), there was no significant difference in the total response rate between the two groups. 13 cases (35.1%) of grade 鈪，
本文编号：2213119
本文链接：https://www.wllwen.com/yixuelunwen/xxg/2213119.html
最近更新
教材专著
