分化诱导剂联合雄激素或小剂量化疗药物治疗骨髓增生异常综合征

THE TREATMENT OF MYELODYSPLASTIC SYNDROMES WITH THE COMBINATIONS OF DIFFERENTIATION INDUCING AGENTS AND ANDROGENS OR LOW DOSE CHEMOTHERAPY

报道３６例骨髓增生异常综合征（ＭＤＳ）的治疗效果。原始细胞不增多的ＭＤＳ（ＲＡ和ＲＡＳ）１７例，以雄激素丙酸睾丸素或康力龙联合分化诱导剂全反式维甲酸和１，２５（ＯＨ）２Ｄ３治疗，部分病例尚加用小剂量强的松；原始细胞增多的ＭＤＳ（ＲＡＥＢ、ＣＭＭＬ及ＲＡＥＢＴ）１９例，以小剂量阿糖胞苷或／和小剂量阿克拉霉素化疗并联用分化诱导剂。前组的有效率为７０．６％，基本缓解率为２９．４％，后组的有效率为５７．９％，完全缓解（ＣＲ）率为３６．８％，两组的总有效率为６３．９％。５例取得基本缓解的ＲＡ和ＲＡＳ目前都处于缓解期，已６个月～１６个月；７例ＣＲ的ＲＡＥＢ和ＲＡＥＢＴ３例于ＣＲ后６个月～１２个月转为急性白血病，另４例仍处于ＣＲ中，已３个月～５２个月。认为根据ＭＤＳ患者的类型予不同的药物联合治疗可取得较好的疗效。

patients with myelodysplastic syndrome (MDS) were treated with different combinations of androgens, all trans retinoic acid, 1,25 dihydroxy vitamin D 3, low dose Ara C and low dose aclarubicin. The aim was to study the efficacy of each combinations. The total effective rate was 63.9%. The overall rate was 70.6% in 17 cases of MDS without excess of blasts (RA and RAS), while 57.9% in 19 cases of MDS with excess of blasts (RAEB, CMML and RAEBT). It is suggested that the combinations of differentiation inducing agents with androgens or low dose chemotherapy are effective in the treatment of MDS.