骨髓增生异常综合症65例临床疗效分析

Clinical therapeutic effects of 65 patients with myelodysplastic syndrome

目的比较骨髓增生异常综合征（Myelodysplastic syndrome,MDS）各型治疗方法。方法我们把65例MDS患者分成四组,采用相应的治疗方法治疗3月观察疗效。结果1常规治疗组完全缓解及进步共8例,有效率47.1%,无效9例,占53.9%;2环孢菌素组完全缓解及进步共7例,有效率为58.3%,无效5例占41.6%;3维生素B6组6例均无效;4化疗组完全缓解及进步共11例（36.7%）,无效19例占63.3%。在11例需4周输血的患者中,6例贫血情况得到改善,输血间隔时间延长至6~8周。51例血小板减少患者中,14例血小板计数增加了50%以上。9例脾大者均有缩小,5例缩小50%以上。老年患者治疗效果不理想。结论本组患者的治疗疗效均不很理想,老年患者在治疗中药物毒副作用较明显,支持治疗和对伴发病的处理更重要。

Objective To compare the therapeutic effect of several different therapeutic regimens on myelodysplastic syndrome （MDS）. Methods 65 patients with myelodysplastic syndrome were divided into 4 groups. Patients in different groups were treated with different therapeutic regimens, and after 3 months the therapeutic effects were observed. Results In conventional therapy group,8 patients were completely remitted or improved and 9 patients were invalid. In cyclosporine therapy group, 7 patients were completely recovered or improved and 5 patients were invalid. In vitamin B6 therapy group, all the 6 patients ended in a failure. In chemotherapy group, 11 patients were completely remitted or improved and 19 patients were invalid. Among the 11 patients who needed 4 weeks transfusion therapy, 6 patients＇ anemia was improved and the interval time of transfusion prolonged to 6-8 weeks. Among the 51 patients with thromhocytopenia, 14 patients＇ blood platelets counts were increased by 50%. All the 9 splenomegaly patients＇ spleens were diminuted and 5 of them got 50~ diminution. While the gerontal patients＇ therapeutic effects were not desirable. Conclusion The therapeutic effects in this series are generally not satisfactory, and there are obvious side effects in gerontal patients during therapy. So supportive therapy and measures targeting at concomitant diseases are very important to MDS patients.