地西他滨联合HAD方案和FLAG方案治疗复发难治性急性髓系白血病的效果观察

Effects of decitabine combined with HAD protocol and FLAG protocol on relapsed and refractory acute myeloid leukemia

目的探讨地西他滨联合HAD方案和FLAG方案治疗复发难治性急性髓系白血病的效果及不良反应发生情况。方法选择2012年1月至2016年3月在临汾市人民医院就诊的58例复发难治性急性髓系白血病患者作为研究对象,采用随机数字表法分为A组和B组,每组29例。A组给予地西他滨联合HAD方案化疗,B组给予FLAG方案化疗。观察比较两组临床有效率、不良反应发生情况和中位生存时间。结果两组有效率比较差异未见统计学意义(χ^2=1.957,P=0.162),但A组完全缓解率高于B组(χ^2=4.549,P=0.033)。A组中位生存时间为15.2个月,B组为10.7个月,差异有统计学意义(χ^2=4.037,P=0.045)。两组白细胞计数最低中位值、粒细胞缺乏中位时间、感染部位、转氨酶异常、胆红素升高、肌酐升高、恶心呕吐等不良反应发生率比较差异均未见统计学意义(P均>0.05)。结论地西他滨联合HAD方案治疗复发难治性急性髓系白血病可提高患者的完全缓解率,延长生存时间,且未增加不良反应发生率,值得进一步研究探讨。

Objective To study the effects of decitabine combined with HAD protocol and FLAG protocol on relapsed and refractory acute myeloid leukemia, and study incidence of postoperative adverse reactions. Methods Fifty-eight patients with relapsed and refractory acute myeloid leukemia in Linfen People’s Hospital from January 2012 to March 2016 were selected as research objects, and the patients were randomly divided into group A and group B, with 29 cases in each group. Patients in group A were treated with decitabine combined with HAD protocol, and patients in group B were treated with FLAG protocol. The clinical effective rate, incidence of adverse reaction and median survival time were observed and compared between the two groups. Results There was no significant difference in the effective rate between the two groups (χ2=1.957, P=0.162), but the complete remission rate in group A was significantly higher than that in group B (χ2=4.549, P=0.033). The median survival time in group A was 15.2 months, and it was 10.7 months in group B, moreover, the difference was statistically significant between the two groups (χ2=4.037, P=0.045). There was no significant difference in the incidence of adverse reactions between the two groups, such as lowest median value of white blood cell count, median time of granulocyte deficiency, location of infection, abnormal transaminase, increase in bilirubin, increase in creatinine, nausea and vomiting (P>0.05). Conclusions Decitabine combined with HAD in treatment of relapsed and refractory acute myeloid leukemia can improve the complete remission rate, prolong the survival time without increase in the incidence of adverse reactions, which is worthy of further research and discussion.