国产地西他滨为主的方案治疗血液系统恶性疾病疗效观察

Evaluation of the efficacy of decitabine based chemotherapy for the treatment of hematologic malignancies

目的:探讨以国产地西他滨为主的方案治疗血液系统恶性疾病的临床疗效及不良反应。方法:回顾性分析2013年1月至2015年3月在本院血液科接受国产地西他滨方案化疗的20例骨髓增生异常综合征(MDS)及10例急性髓系白血病(AML)患者的临床资料,评价其疗效和不良反应。结果:20例MDS患者中完全缓解4例,部分缓解2例,病情稳定8例,病情进展4例,死亡2例。疾病控制率70%,有效率30%,血液学不良反应发生率100%,感染发生率40%,严重出血1例,无肝功能损伤发生。10例AML患者中缓解3例,部分缓解2例,未缓解5例。结论:国产地西他滨为主的化疗方案可有效治疗骨髓增生异常综合征及急性髓细胞白血病,虽然血液学不良反应较重,感染的发生率较高,但患者基本上可耐受,给予相应抗炎及支持治疗可得到有效控制。

Objective： To explore clinical efficacy of decitabine for the treatment of hematologic malignancies. Methods： Clinical data of 20 patients with myelodyslastic syndromes （MDS） and 10 patients with acute myeloid leukemia （AML） treated with decitabine in hematology department of our hospital from Jan. 2013 to Mar. 2015 were analyzed retrospectively. The efficacy and adverse reaction were evaluated. Results： Of all the patients with MDS, 4 patients achieved complete remission and 4 achieved partial remission. The response rate was 70%. The incidence of hematologic toxicity and infection was 100% and 33.3% respectively, and that of severe bleeding and mild liver injury was 10% and 0 respectively. No severe nausea and vomiting were observed. Conclusion： Decitabine can effectively treat MDS refractory or relapsed AML. Although higher,patients can tolerate them. Anti-inflammatory and the hematologic toxicity is more serious and the infection rate is supportive treatment should be given to reduce the side effects.