CAG方案、复方黄黛片联合CAG方案、地西他滨联合CAG方案治疗老年急性髓系白血病的疗效比较

The Clinical Efficacy of the Elderly Patients of Acute Myeloid Leukemia Treatment with CAG Regimen alone,Combined with Compound Huangdai Tablets or Decitabine

目的:比较单用CAG方案、复方黄黛片联合CAG方案及地西他滨联合CAG方案治疗老年急性髓系白血病(AML)的临床疗效及其安全性。方法:回顾性分析18例患者接受CAG方案、19例患者接受复方黄黛片联合CAG方案及20例患者接受地西他滨联合CAG方案治疗的临床资料,分别比较三组患者的总反应率(ORR)、总生存(OS)率及不良反应发生率。结果:单用CAG方案组、复方黄黛片联合CAG方案组及地西他滨联合CAG方案组的ORR分别为50.0%、63.2%和65.0%,三组比较差异无统计学意义(P>0.05),其不良反应主要为感染和出血。复方黄黛片联合CAG方案组患者化疗后输血中位时间及粒缺期时间较单用CAG方案组短,差异具有统计学意义(P<0.05)。结论:复方黄黛片联合CAG方案及地西他滨联合CAG方案治疗老年AML的疗效比较好,且复方黄黛片联合CAG方案不良反应少,患者耐受性好,并有增效减毒作用。

Objective： To investigate the effects and safety of alone CAG regimen,Compound Huangdai Tablets（ CHDT） combined with CAG regimen and decitabine combined with CAG regimen on old patients with acute myeloid leukemia. Methods ： 57 patients with relapsed and refractory AML were treated with compound Huangdai Tablets and CAG regimen and alone CAG regimen and decitabine combined with CAG regimen with the efficacy and adverse reactions were observed. We observed complete remission（ CR） rate,overall response rate（ ORR） and overall survival（ OS） of the three groups; Meanwhile,we analyzed the factors relevant to decitabine efficacy and the prognosis. Results： In the 57 patients,there were 14 with complete remission（ CR）（ 37. 8%）,9 with partial remission（ PR）（ 24. %）,and 1 with disease progression（ PD）（ 5. 4%）. The overall response rate（ ORR） was 56. 8%. The observation group was 8 with complete remission（ CR）（ 44. 4%）,ORR was 65. 5%,The control group was 6 with complete remission（ CR）（ 31. 6%）,ORR was 52. 6%. Although the observation group was more effective than the control group,but there was no statistical significance（ P 0.05）. The main adverse reactions were infection and bleeding were mainly caused by decitabine,which were alleviated after symptomatic treatment. There were statistically significant differences（ P 0. 05） among the three groups in teams of blood transfusion time and lower ANC time. Conclusion： Compound Huangdai Tablets and CAG regimen show good effects,few adverse reactions and toxicity reducing in the treatment of old Patients AML.