地西他滨联合预激方案初治高危骨髓增生异常综合征及老年急性髓系白血病的临床观察

The clinical observation of decitabine combined with CAG regimen for the high-risk myelodysplastic syndrome and elderly acute myeloid leukemia

目的:探讨地西他滨(DAC)联合预激方案初次治疗高危骨髓增生异常综合征(MDS)及老年急性髓系白血病(AML)的疗效和不良反应。方法:回顾性分析首次接受DAC联合预激方案(DAC 25 mg qd,d_(1～5);Ara-C 10 mg/m^2q12h,d_(6～12); Acla 12 mg/m^2qd,d_(6～9); G-CSF 200μg/m^2qd,WBC> 20×10~9/L则停用)治疗26例高危MDS及老年AML患者的疗效和不良反应。结果:26例高危MDS及老年AML患者中,完全缓解率42. 3%,总体反应率(完全缓解+部分缓解) 65. 4%,中位生存时间为16. 2个月。结论:DAC联合预激方案治疗高危MDS及老年AML患者疗效确切,且安全性高,但由于本研究样本量较小,需进一步开展多中心随机对照试验证实。

Objective To explore the efficacy and side effects of decitabine( DAC) combined with CAG regimen for high-risk myelodysplastic syndrome( MDS) and elderly acute myeloid leukemia( AML). Methods: A retrospective analysis was performed on the efficiency and side effects of DAC combined with CAG regimen( DAC 25 mg qd,d1~5,Ara-C 10 mg/m^2 q12 h,d6~12,Acla 12 mg/m^2 qd,d6~9,G-CSF 200 μg/m^2 qd,WBC > 20 × 10^9/L then stop)for 26 cases of high-risk MDS and elderly AML. Results: Among the 26 cases of high-risk MDS and elderly AML,complete remission( CR) rate was 42. 3%. The clinical efficiency( CR + PR) was 65. 4%. None of the patients died early. Median survival time was 16. 2 months. Conclusion: The DAC combined with CAG regimen for high-risk MDS and elderly AML patients had definite therapeutic effect,and high safety. Due to the small sample cohort,multicenter randomized controlled trial is necessary.