地西他滨治疗骨髓增生异常综合症疗效观察

Clinical observation of myelodysplastic syndrome treated with decitabine

目的观察分析地西他滨治疗骨髓增生异常综合症(MDS)的临床疗效及不良反应。方法回顾性分析该院在2013年以来收治的37例MDS患者临床资料,对单用地西他滨治疗MDS的临床疗效及不良反应进行评估。结果37例MDS患者中,2例患者因第1疗程后出现出血及感染而死亡,不能判断疗效;35例患者中完全缓解(CR)9例(25%),血液学改善18例,病情稳定8例,总有效率(ORR)为77%(CR 9例,HI 18例),中位OS时间为21.1(95%CI:16.0~26.1)个月;ANC缺乏持续中位时间18(12~38)d,PLT<20×10 9/L,持续中位时间15(10~53)天;13例患者分别发生牙龈脓肿及败血症,感染发生率35%,23例(62%)未发生严重脏器功能损害。结论地西他滨治疗MDS临床疗效确切,血细胞减少和感染为主要不良反应;采用何种剂量地西他滨疗效最佳需进一步扩大样本量及延长病例随访时间进行观察。

Objective To observe and analyze the clinical efficacy and adverse effects of decitabine in the treatment of myelodysplastic syndromes(MDS).Methods The clinical of 37 cases of MDS during the past of 4 years in Panyu central hospital were analyzed retrospectively.The MDS patients were treated with single decitabine;the curetive efficacy and adverse reactions were evaluated.Results In 37 patients with MDS,2 patients died of bleeding and infection in the first courses of treatment and cannot judge curative effect.In 35 patients,complete remission(CR)occurred in 9 patients(25%9/35),hematologic improvement in 2 cases,total effective rate(ORR)was 77%(27/35,CR9,HI in 18),median OS time was 21.1(95%CI,16.0-26.1)months;The median duration of ANC lacked was 18(12~38)days,Plt<20*10^9/L,and median duration was 15(10~53)days;Gingival abscess and septicemia occurred in 13 patients.The incidence of infection was(35%13/37),and no serious organ function damage occurred in 23 cases(62%23/37).Conclusion The clinical efficacy of capecitabine in the treatment of MDS is definite,and the decrease of blood cells and infection are the major adverse effects.It is necessary to further expand the sample size and prolong the follow-up time to observe the dose of capecitabine.