地西他滨治疗老年急性髓系白血病疗效及安全性分析

Efficacy and safety analysis of decitabine in the treatment of acute myeloid leukemia in the elderly

目的：探讨以地西他滨为基础的化疗方案治疗老年急性髓系白血病（ AML）的临床疗效及安全性。方法回顾性地分析2013年1月至2016年2月盐城市第三人民医院血液科收治的29例老年AML患者的临床资料，根据其是否使用地西他滨分为地西他滨组和传统方案组，对比评定疗效。结果地西他滨组和传统方案诱导后的完全缓解率分别为60.0％（6／10）和35.7％（5／14），差异有统计学意义（P＜0．05）；同时两组的总生存期差异有统计学意义（44.9 vs 13.6个月，P＜0．05）。80.0％老年AML患者在使用以地西他滨为基础的化疗方案治疗过程出现不同程度的不良反应，仅30.0％的患者发生了Ⅲ～Ⅳ级不良反应，主要为中性粒细胞减少和血小板减少。结论地西他滨为基础的化疗方案有较高的缓解率，且可延长生存期。

Objective To evaluate the efficacy and safety of decitabine in the treatment of acute myeloid leukemia （ AML） in the elderly.Methods Retrospective analysis was conducted on 29 elderly AML patients admitted in our hospital from Jan.2013 to Feb. 2016.They were divided into decitabine treatment group and conventional treatment group.Clinical outcomes and adverse reactions were observed and compared between the 2 groups.Results The complete remission （CR） rate was 60.0%（6/10） in the decitabine group, and 35.7%（5/14） for the conventional group, with significant difference between the 2 groups （ P 〈0.05）.Significant difference was also seen in the overall survival between them （44.9 vs 13.6 months, P〈0.05）.Various adverse events （AE） were identified in 80.0%patients from the decitabine group.Only 30.0% （3 patients） were Ⅲ-Ⅳ grade of AE, mainly manifested as neutropenia and thrombocytopenia.Conclusion Decitabine-based chemotherapy regimen is of higher response rate and prolongs survival in the treatment of AML in the elderly.