地西他滨治疗复发难治性急性髓系白血病的效果和安全性观察

Observation on the Efficacy and Safety of Decitabine in the Treatment of Relapsed and Refractory Acute Myeloid Leukemia

目的探讨地西他滨治疗复发难治性急性髓系白血病(AML)的临床疗效及安全性。方法选取32例复发性或难治性AML患者作为研究对象,采用地西他滨联合HAG方案治疗,治疗2个疗程后评价疗效及治疗安全性,随访观察患者的远期疗效。结果治疗2个疗程后,32例患者中CR 5例,PR 7例,NR 20例,总缓解率为37.50%,核型为良、中等、不良患者的缓解率依次降低(P<0.05)。WBC减少、PLT减少及胃肠不适的发生率较高,分别为100.00%、93.75%、93.75%,其次为肝肾损伤和感染。治疗后随访2年,32例患者中死亡28例,存活4例,死亡患者的生存时间为2.2~21.8个月,平均(8.1±1.6)个月。结论地西他滨联合HAG方案治疗复发性、难治性AML,早期治疗缓解率不高,药物不良反应明显,远期疗效不佳。

Objective To explore the clinical efficacy and safety of decitabine in the treatment of relapsed and refractory acute myeloidleukemia（AML）.Methods 32 cases of relapsed or refractory AML patients were selected as research objects. All cases were treated with decitabine combined with HAG regimen. The effcacy and safety of treatment were evaluated alter 2 weeks of treatment. All patients were followed up to observe the long-term efficacy. Results After 2 weeks of treatment, the overall remission rate was 37.50%, with 5 cases ofCR, 7 cases of PR and 20 cases of NR; The remission rates of patients with good, moderate and bad karyotype decreased successively （P 〈0.05）. The incidences of WBC reduction, PLT reduction and gastrointestinal discomfort were 100.00%, 93.75% and 93.75% respectively, following by liver / kidney injury and infection. During 2 years＇ follow-up, 28 cases were dead and 4 cases were survival; The survival time of death cases was 2.2 - 21.8 months, with the mean time of（8.1 ± 1.6） months. Conclusions Decitabine combined with HAG regimen in the treatment of relapsed and refractory AML has low early remission rate, obvious adverse drug reactions and poor long-term efficacy.