重组人血小板生成素治疗急性白血病化疗后血小板减少临床疗效观察
发布时间：2019-01-14 10:15
【摘要】：目的观察重组人血小板生成素(rh TPO)治疗急性白血病化疗后血小板减少的临床疗效。方法对125例于青岛大学附属医院血液内科住院的急性白血病化疗后血小板减少的患者,进行回顾性分析研究。其中男性65例,女性60例。按疾病类型来分,急性髓系白血病87例,急性淋巴细胞白血病38例。其中在急性髓系白血病中,急性髓细胞白血病微分化型(M0)1例,急性粒细胞白血病未分化型(M1)10例,急性粒细胞白血病部分分化型(M2)20例,急性早幼粒细胞白血病(APL)10例,急性粒-单核细胞白血病(M4)23例,急性单核细胞白血病(M5)22例,红白血病(M6)1例。入院后评估患者无化疗禁忌后,立即给予化疗。化疗药物中以蒽环类及蒽醌类为基础药物,并联合阿糖胞苷。化疗方案中急性髓系白血病主要为DA方案(阿糖胞苷+柔红霉素)、IDA方案(阿糖胞苷+去甲氧柔红霉素)、TA方案(吡喃阿霉素+阿糖胞苷)、MA方案(米托蒽醌+阿糖胞苷)、EA方案(依托泊苷+阿糖胞苷)、HA方案(高三尖杉酯+阿糖胞苷)等为主。急性淋巴细胞白血病主要为VP(长春新碱+泼尼松)、VDP(长春新碱+泼尼松+柔红霉素)及VDCLP方案(长春新碱+地塞米松、泼尼松+柔红霉素+环磷酰胺+左旋门冬酰胺酶)等化疗方案进行。急性白血病化疗后进入骨髓抑制期,骨髓抑制引起巨核细胞系增生减低,进而引起血小板减少。不同化疗阶段及强度引发骨髓抑制不同,引起的血小板减少的持续时间也不同。随后将125例急性白血病化疗后血小板减少患者按治疗阶段分为诱导缓解治疗组、巩固治疗组、强化治疗组,后再分别分为实验组和对照组,当血小板计数≤30×109/L时,给予实验组皮下注射重组人血小板生成素15 000 U,给予对照组皮下注射重组人白介素-11(rh IL-11),用药时间为7-14天,用药时间到达14天或当血小板计数上升至5 0×109/L,停药;有出血倾向或血小板计数20×109/L时,给予应用止血药物预防出血或止血。必要时给予输注去白细胞单采血小板1治疗量。比较各组患者在年龄、性别、疾病类型等方面无明显差异后,观察并记录三个治疗阶段的实验组和对照组血小板计数50×109/L的持续时间、恢复到70×109/L和100×109/L的时间,并观察实验组和对照组输血次数及不良反应发生率。并运用合适的统计学方法分析数据。结果诱导缓解治疗组、巩固治疗组、强化治疗组的实验组血小板计数50×109/L的持续时间、恢复到70×109/L和100×109/L的时间显著低于对照组(P0.05);实验组输注血小板次数显著少于对照组(P0.05)。实验组的不良反应出现率显著低于对照组(3.2%15.6%)(P0.05)。结论重组人血小板生成素(rh TPO)用于治疗急性白血病化疗后血小板减少的疗效好,不良反应少。
[Abstract]:Objective to observe the clinical effect of recombinant human thrombopoietin (rh TPO) on thrombocytopenia after chemotherapy in acute leukemia. Methods 125 patients with thrombocytopenia after chemotherapy in Department of Hematology, affiliated Hospital of Qingdao University were studied retrospectively. There were 65 males and 60 females. According to the type of disease, 87 cases of acute myeloid leukemia and 38 cases of acute lymphoblastic leukemia. Among them, 1 case of acute myeloid leukemia (M0), 10 cases of acute myeloid leukemia (M1), 20 cases of partial differentiation (M2) of acute myeloid leukemia (AML), and 1 case of M0, 10 cases of undifferentiated type of acute myeloid leukemia (M1), 20 cases of partial differentiation of acute myeloid leukemia (M2). There were 10 cases of acute promyelocytic leukemia (APL), 23 cases of acute myelo-monocytic leukemia (M4), 22 cases of acute monocytic leukemia (M5) and 1 case of erythroleukemia (M6). After admission, the patients were given chemotherapy immediately after no contraindication of chemotherapy. Anthracyclines and anthraquinones are the basic drugs in chemotherapeutic drugs, combined with cytarabine. In the chemotherapy regimen, acute myeloid leukemia was mainly DA regimen (cytarabine daunorubicin), IDA regimen (cytarabine normodaunorubicin), TA regimen). MA regimen (mitoxantrone cytarabine), EA regimen (etoposide cytarabine), HA regimen), etc. VP (vincristine prednisone), VDP () and VDCLP regimen (vincristine dexamethasone) were the main types of acute lymphoblastic leukemia. Prednisone daunorubicin cyclophosphamide (L-asparaginase) and other chemotherapy regimen. After chemotherapy, acute leukemia enters the stage of bone marrow suppression, which leads to the decrease of megakaryocyte cell line proliferation, and then to thrombocytopenia. The duration of thrombocytopenia was different in different stages and intensity of chemotherapy. Then 125 patients with thrombocytopenia after chemotherapy in acute leukemia were divided into three groups: induction remission group, consolidation treatment group, intensive treatment group, and then divided into experimental group and control group respectively. When platelet count was 鈮，
本文编号：2408601
[Abstract]:Objective to observe the clinical effect of recombinant human thrombopoietin (rh TPO) on thrombocytopenia after chemotherapy in acute leukemia. Methods 125 patients with thrombocytopenia after chemotherapy in Department of Hematology, affiliated Hospital of Qingdao University were studied retrospectively. There were 65 males and 60 females. According to the type of disease, 87 cases of acute myeloid leukemia and 38 cases of acute lymphoblastic leukemia. Among them, 1 case of acute myeloid leukemia (M0), 10 cases of acute myeloid leukemia (M1), 20 cases of partial differentiation (M2) of acute myeloid leukemia (AML), and 1 case of M0, 10 cases of undifferentiated type of acute myeloid leukemia (M1), 20 cases of partial differentiation of acute myeloid leukemia (M2). There were 10 cases of acute promyelocytic leukemia (APL), 23 cases of acute myelo-monocytic leukemia (M4), 22 cases of acute monocytic leukemia (M5) and 1 case of erythroleukemia (M6). After admission, the patients were given chemotherapy immediately after no contraindication of chemotherapy. Anthracyclines and anthraquinones are the basic drugs in chemotherapeutic drugs, combined with cytarabine. In the chemotherapy regimen, acute myeloid leukemia was mainly DA regimen (cytarabine daunorubicin), IDA regimen (cytarabine normodaunorubicin), TA regimen). MA regimen (mitoxantrone cytarabine), EA regimen (etoposide cytarabine), HA regimen), etc. VP (vincristine prednisone), VDP () and VDCLP regimen (vincristine dexamethasone) were the main types of acute lymphoblastic leukemia. Prednisone daunorubicin cyclophosphamide (L-asparaginase) and other chemotherapy regimen. After chemotherapy, acute leukemia enters the stage of bone marrow suppression, which leads to the decrease of megakaryocyte cell line proliferation, and then to thrombocytopenia. The duration of thrombocytopenia was different in different stages and intensity of chemotherapy. Then 125 patients with thrombocytopenia after chemotherapy in acute leukemia were divided into three groups: induction remission group, consolidation treatment group, intensive treatment group, and then divided into experimental group and control group respectively. When platelet count was 鈮，
本文编号：2408601
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