地西他滨联合不同化疗方案治疗复发难治性急性髓系白血病疗效观察

Clinical Observation of Decitabine Combined with Different Chemotherapy Regimens in Treating Recurrent Refractory Acute Myeloid Leukemia

目的观察地西他滨联合不同化学治疗(化疗)方案治疗复发难治性急性髓系白血病(AML)的临床疗效。方法选取医院2012年1月至2015年2月收治的复发难治性AML患者86例,按随机数字表法分为对照组和观察组,各43例。对照组患者给予地西他滨联合改良CAG(阿糖胞苷+阿克拉霉素+粒细胞集落刺激因子)方案治疗,观察组患者给予地西他滨联合减量FLAG(氟达拉滨+阿糖胞苷+粒细胞集落刺激因子)方案治疗。结果观察组患者总有效率和死亡率分别为62.79%和16.28%,优于对照组的58.14%和18.60%,但组间比较均无显著性差异(χ~2=0.19,0.08;P>0.05);治疗后,观察组患者总生存时间和无复发生存时间分别为(32.68±4.36)个月和(19.74±3.18)个月,优于对照组的(31.05±2.05)个月和(18.32±2.34)个月,但组间比较无显著性差异(t=5.84,10.04;P>0.05);两组患者血小板减少、中性粒细胞减少、恶心呕吐、感染等不良反应发生率均无显著性差异(P>0.05)。结论采用地西他滨联合减量FLAG方案治疗和联合CAG方案治疗复发难治性AML的临床疗效相当,为该病恩环类化疗药物累积超量的患者提供了有效的化疗方案。

Objective To investigate the clinical efficacy of decitabine combined with different chemotherapy regimens in treating recurrent refractory acute myeloid leukemia（ AML）. Methods A total of 86 patients with recurrent refractory AML admitted to our hospital from January 2012 to February 2015 were randomly divided into the control group and the observation group according to the random number table method,43 cases in each group. The control group was given decitabine combined with CAG regimen（ cytosine arabinoside ＋aclacinomycin ＋ granulocyte colony-stimulating factor）,while the observation group were treated with decitabine combined with reduced FLAG regimen（ fludarabine ＋ cytosine arabinoside ＋ granulocyte colony-stimulating factor）. Results The total effective rate and mortality rate of the observation group were 62. 79% and 16. 28%,respectively,which were better than 58. 14% and 18. 60% of the control group,but there was no significant difference between the two groups（ χ2 = 0. 19,0. 08,P 0. 05）. After treatment,the survival time and recurrence-free survival time of the observation group were（ 32. 68 ± 4. 36） months,（ 19. 74 ± 3. 18） months,which were better than（ 31. 05 ± 2. 05） months,（ 18. 32 ± 2. 34） months of the control group,but there was no significant difference between the two groups（ t = 5. 84,10. 04,P 0. 05）. There was no significant difference in the incidence of adverse events such as thrombocytopenia,neutropenia,nausea and vomiting and infection（ P 0. 05）. Conclusion The decitabine combined with reduced FLAG regimen and decitabine combined with CAG regimen for treating recurrent refractory AML have comparable clinical efficacy,it can provide an effective chemotherapy regimen for patients with excess cumulative chemotherapy.