小剂量HA方案联合亚砷酸治疗高危骨髓增生异常综合征疗效观察

Effect of low-dose homoharringtonine and cytarabine regimen combined with arsenic trioxide on high-risk myelodysplastics syndromes

目的观察小剂量HA方案(高三尖杉酯碱+阿糖胞苷)联合亚砷酸治疗高危骨髓增生异常综合征的临床效果。方法 37例高危骨髓增生异常综合征患者,依据国际预后评分系统分为中危Ⅱ组19例及高危组18例,2组均应用小剂量HA方案联合亚砷酸治疗,每28d为1个疗程,3个疗程后判定疗效,并随访观察2组2a生存率。结果中危Ⅱ组有效率为89.47%,完全缓解率为42.11%;高危组有效率为83.33%,完全缓解率为27.78%,2组有效率比较差异无统计学意义(P>0.05),完全缓解率比较差异有统计学意义(P<0.05);中危Ⅱ组2a生存率(36.84%)高于高危组(27.78%)(P<0.05)。结论小剂量HA方案联合亚砷酸治疗高危骨髓增生异常综合征安全、有效,对中危Ⅱ组患者完全缓解及生存改善较好。

Objective To observe the effect of low-dose homoharringtonine and cytarabine （HA） regimen combined with arsenic trioxide on high-risk myelodysplastics syndromes （MDS）. Methods Thirty-seven patients with high-risk MDS were divided into moderate-risk-II group （n= 19） and high-risk group （n= 18） according to the International Prognostic Scoring System score. Both two groups were treated with HA regimen combined with arsenic trioxide for 28 days as one course. The effect was assessed after 3 courses and the two-year survival rate was observed. Results The total effective rate was 89.47% in moderate-risk-II group and 83.33 % in high-risk group, showing no significant difference between two groups （P〉0.05）. The complete response rate was 42. 11% in moderate-risk-II group and 27. 78% in high-risk group, showing a significant difference between two groups （P〈0.05）. The two-year total survival rate was 36.84% in moderate-risk-H group, significantly higher than that in high-risk group （27.78%） （P〈0.05）. Conclusions Low-dose HA regimen combined with arsenic trioxide is safe and effective for myelodysplastics syndromes. Moderate-risk-II patients have a better complete response and survival improvement.