低剂量地西他滨治疗骨髓增生异常综合征的疗效分析

Effect of low dose Decitabine on myelodysplastic syndromes

目的:观察低剂量地西他滨治疗骨髓增生异常综合征(MDS)的疗效及安全性。方法:9例骨髓增生异常综合征患者应用地西他滨20mg/m2.d,静脉滴注,持续时间大于1小时,连续5天,至少连续2疗程,观察MDS患者病程的改变、生存质量和血液学指标等。依据NCICTCAE标准判断药物不良反应。结果:1例CR、1例PR、2例获得血液学改善,输血频次减少;上述4例治疗有反应的MDS患者均在随访中,目前尚未转为急性白血病;5例患者疾病进展,2周期治疗后,输血频次无明显减少,复查骨髓细胞学呈低增生性,且原始细胞比例较治疗前无明显下降,其中有2例MDS-RAEB 2 IPSS评分为高危患者原始细胞比例明显升高,短期内转化为急性髓性白血病。结论:低剂量地西他滨与其他强烈化疗方案相比,安全性强,化疗相关死亡率低,不良反应易于处理。

Objective： Investigating the efficacy and safety of treating myelodysplastic syndrome （MDS） by low - dose decitabine. Methods.. 9 cases of myelodysplastic syndrome were treated with intravenous infusion of decitabine （20mg/m2 · d） , more than 1 hour,5 consecutive days, at least 2 courses. Results： 1 case was CR, 1 case PR,2 cases hematological improvement, reducing the frequency of blood transfusion, these 4 cases of MDS patients who responded to treatment were in follow -up and had not yet become acute leukemia; After 2 cycles of treatment,5 patients had no significant decrease in the frequency of blood transfusion, low proliferative in bone marrow cytology review, and the o- riginal cell ratio decreased insignificantly compared with before treatment. Moreover, two cases transformed into acute myeloid leukemia in short -term. Conclusion： Compared with other strong chemotherapy,treatments with low -dose decitabine is safe.and easier to deal with adverse reactions.