地西他滨联合半剂量CAG方案治疗骨髓增生异常综合征

Myelodysplastic syndrome treated with decitabine and half-dose CAG regimen

目的报道1例骨髓增生异常综合征(MDS)接受地西他滨(达珂)联合半剂量CAG方案(阿糖胞苷+阿克拉霉素+重组人粒细胞刺激因子)化疗后并发严重感染,并进行文献复习。方法 1例老年MDS-RC-MD患者,接受2次达珂联合半剂量CAG方案化疗,2次化疗后均出现骨髓抑制、粒细胞缺乏、发热及感染,且第2次化疗过程中感染更严重。治疗过程中均给予抗感染、输血等对症治疗。结果患者感染好转,血小板和血红蛋白上升,脱离了输血依赖。结论达珂治疗MDS血液学改善显著,但治疗过程中可并发严重感染,值得重视。

Objective To study the myelotoxicity and pulmonary infection in a patient with myelodysplastic syndrome (MDS) treated with decitabine and half-dose cytaraline, aclarnlincin, granulocyte conlony-stimuluting factor(CAG) regimen. Methods A patient with MDS received a variety of regular treatments with no response and presented blood transfusion dependency and then two cycles of decitabine combined with half-dose CAG regimen in May and July 2011, respectively. The patient appeared severe myelosuppression, agranulocytopenia, fever and pulmonary infection after each cycle of chemotherapy. Blood transfusion and anti-infection therapy were administered to the patient according to the symptoms. Results Pulmonary infection was controlled significantly and the patients achieved hematologic improvement and became transfusion-free. Conclusions Elderly patients with MDS can achieve significant hematologic response after treatment of decitabine. Severe hematologic toxicity and infection could be observed and should be treated.