小剂量HAG方案与地西他滨联用对25例老年急性髓系白血病的治疗效果及安全性分析

Efficacy and Safety of Low-dose HAG Regimen Combined with Dietabine in the Treatment of 25 Elderly Patients with Acute Myeloid Leukemia

目的分析小剂量HAG方案与地西他滨联用对25例老年急性髓系白血病的治疗效果及安全性。方法回顾性选取2015年8月至2016年12月我院收治的25例老年急性髓系白血病患者的临床资料,根据治疗方法不同分为对照组和观察组。对照组患者采用传统MA方案治疗,观察组患者采用小剂量HAG方案联合地西他滨治疗,分析两组患者治疗后的临床效果。结果观察组患者总有效率为76.92%,对照组为50.00%,观察组患者总有效率高于对照组,但组间比较差异无统计学意义(P>0.05)。治疗前,两组患者免疫功能指标、ANC、COX-2、VEGF、LDH水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者CD4+、CD4+/CD8+、ANC水平高于对照组,CD8+、COX-2、VEGF、LDH水平低于对照组,差异有统计学意义(P<0.05)。两组患者恶心呕吐、心脏毒性、血液学毒性、肝肾毒性等毒副反应情况比较,差异无统计学意义(P>0.05)。结论小剂量HAG方案联合地西他滨治疗老年急性髓系白血病可降低患者COX-2、VEGF、LDH水平,提高机体免疫功能,不良反应较轻,安全性高。

Objective To evaluate the clinical efficacy and safety of low dose HAG regimen combined with dexcitabine in the treatment of 25 elderly patients with acute myeloid leukemia. Methods The clinical data on 25 elderly patients with acute myeloid leukemia treated between August 2015 and December 2016 was retrospectively analyzed and divided into the control group and observation group according to treatment methods. The patients in the control group were treated with traditional MA regimens,while those in the observation group were treated with a low-dose HAG regimen combined with dicitabine. The clinical effects of the two groups were analyzed. Results The total effective rate of the observation group was 76. 92 and that of the control group was 50. 00. The total effective rate of the observation group was higher than that of the control group,but there was no significant difference between the two groups（ P〈0. 05）. Before treatment,there was no significant difference in the level of LDH between the two groups（ P〈0. 05）. After treatment,the levels of CD4 CD4/CD8 ＋ ANC in the observation group were significantly higher than those in the control group（ P〈0. 05）. There was no significant difference in adverse reactions,such as nausea and vomiting,cardiac toxicity,hematological toxicity and hepatorenal toxicity,between the two groups（ P〈0. 05）. Conclusion The low dose HAG regimen combined with dietabine in the treatment of elderly patients with acute myeloid leukemia can reduce the level of COX-2 VEGF,improve the immune function of the body. Adverse reactions are mild and it is quite safe.