中西医结合治疗低中危骨髓增生异常综合征22例疗效分析

Effect of Chinese-western-combined Therapy for 22 Patients with Low and Intermediate-risk Myelodysplastic Syndrome

目的:评价中西医结合治疗低中危骨髓增生异常综合征(MDS)的近期临床疗效,及其该治疗方法对输血依赖和生存情况的影响。方法:对22例低中危MDS患者采用中医药为主配合常规造血刺激和支持治疗,疗程至少6个月。结果:完全缓解3例,部分缓解1例,骨髓完全缓解2例,疾病稳定1例,血液学改善10例,治疗失败5例,总有效率77.3%;红细胞输注依赖改善率69.2%,血小板输注依赖改善率40.0%;中位随访43个月,16例尚存活,6例死亡;生存期7个月~270个月,中位生存期34.5个月,死亡原因包括造血衰竭继发重症感染2例,心力衰竭1例,脑出血1例,转化为急性髓系白血病(AML)死亡2例。结论:中西医结合治疗可提高低中危MDS近期临床疗效,改善输血依赖,远期生存情况有待进一步随访。

Objective： To evaluate the short-term efficacy of Chinese-Western-Combined Therapy for low and intermediate-risk （ IPSS score 0 - 2.0, the same below） myelodysplastic syndrome （MDS） patients and the effect of the treatment on blood transfusion dependence and survival. Methods：With the help of hematopoietic stimulation and supportive care, 22 low and intermediate-risk MDS Patients were mainly received traditional Chinese medicine for at least 6 months. Results：3 achieved complete remission（CR）, 1 partial remission（PR） , 2 bone marrow CR, 1 stable, 10 haematological improvement,5 failure. The overall response rate was 77.3%. The improvement rates of red blood cells transfusion dependence and platelets transfusion dependence were 69.2% and 40. 0% respectively. With a median follow-up of 43 months, 16 were still survival and 6 died. The causes of death include severe infection after bone marrow failure（2） , heart failure（1）, cerebral hemorrhage（ 1 ） and acute myeloid leukemia transformation （2）. The median overall survival was 34. 5months（ranged 7-270 months）. Conclusion：This combined treatment could improve the short-term efficacy of low and intermediate-risk MDS patients and decrease blood transfusion dependence. Its long-term survival needs ongoing follow-up.