超小剂量地西他滨治疗骨髓增生异常综合征的疗效分析

Super Small Dose of Sitabine in Treatment of Myelodysplastic Syndrome

目的分析超小剂量地西他滨治疗骨髓增生异常综合征的临床疗效。方法将泗阳县人民医院2014年3月—2017年9月收治的41例骨髓增生异常患者随机分为两组,均予以地西他滨治疗,用药剂量不同,对照组20例地西他滨给药剂量为15 mg/m2,1次/周,连续治疗4周,7周为1疗程;观察组21例给予5~7 mg/m2,皮下d1、d2、d3、d8、d15、d22,7周1疗程,比较两组疗效及不良反应。结果观察组、对照组治疗总有效率61.90%、60.00%组间比较无明显差异(P=0.901);治疗后两组白细胞计数、血红蛋白均明显升高,且组间比较无明显差异;两组血小板修复时间、血红蛋白恢复时间、粒细胞修复时间组间比较无明显差异;观察组红细胞输注量(0.28±0.04)U明显少于对照组的(2.30±0.42)U(P=0.000),不良反应发生率9.52%明显低于对照组的35.00%(P=0.0249)。结论 5~7 mg/m^2剂量的地西他滨与15 mg/m^2剂量用药方案对骨髓增生异常综合征的治疗效果相当,且5~7 mg/m^2剂量治疗时刻减少红细胞输注量,降低不良反应发生风险,值得推广。

Objective To analyze the clinical efficacy of ultra low dose decitabine treatment of myelodysplastic syndrome. Methods Forty-one patients with abnormal hyperplasia of bone marrow in Siyang People's Hospital from March 2014 to September 2017 were randomly divided into two groups,with decitabine treatment at different medication dosage. In the control group,20 cases of decitabine were administered with a dosage of 15 mg/m^2 once a week for 4 weeks and 1 week for 7 weeks. In the observation group,21 cases were treated with 5-7 mg/m^2 subcutaneous d1,d2,d3,d8,d15,d22,7 weeks and 1 course of treatment,the two groups were compared efficacy and adverse reactions. Results The total effective rate of observation group and control group was 61.90% and there was no significant difference between 60.00%(P=0.901). After treatment,the white blood cell count and hemoglobin of the two groups were significantly increased,and there was no significant difference between the two groups(0.28±0.04)U in the observation group was significantly lower than that of the control group(2.30 0.42)U(P=0.000),adverse reactions The rate of 9.52% was significantly lower than 35.00% of the control group(P=0.0249). Conclusion 5~7 and 15 mg/m^2 of dietabine have the same effect on myelodysplastic syndrome. The dosage of 5~7 mg/m^2 can reduce the amount of red blood cell transfusion and reduce the risk of adverse reaction. It is worth popularizing.