地西他滨联合半程预激方案治疗老年急性髓系白血病疗效分析及不良反应评价

Efficacy Analysis and Adverse Reaction Evaluation of Decitabine Combined with Half-way Pre-excitation Regimen in the Treatment of Acute Myeloid Leukemia in the Elderly

目的应用地西他滨联合半程预激方案治疗老年急性髓系白血病(AML)患者,观察其临床效果和不良反应。方法选取该院2012年1月—2017年4月老年AML患者46例,随机分为对照组和研究组,各23例,对照组患者给予全程CAG预激治疗,研究组患者同时应用地西他滨联合半程预激方案治疗。观察临床疗效、不良反应,记录中性粒细胞和血小板恢复时间,观察患者生存总时间(OS)。结果研究组患者缓解率(RR)和OS分别为69.57%(16/23)和(12.75±0.92)个月,高于对照组为52.17%(12/23)和(10.80±0.86)个月,差异有统计学意义(χ^2=8.650,t=9.800,P<0.05);研究组中性粒细胞和血小板恢复时间分别为(13.52±1.04)d和(14.16±1.12)d,均低于对照组(16.73±1.18)d和(17.08±1.20)d,差异有统计学意义(t=9.930、10.140,P<0.05)。两组患者不良反应比较,差异无统计学意义(P>0.05)。结论应用地西他滨联合半程预激方案治疗老年AML患者,临床疗效显著,能够延长患者生存期,缩短中性粒细胞和血小板恢复时间,且较安全。

Objective To treat the elderly patients with acute myeloid leukemia(AML)with decitabine combined with half-way pre-excitation,and observe its clinical effects and adverse reactions.Methods Forty-six elderly patients with AML from January 2012 to April 2017 were randomly divided into the control group and the study group,23 cases in each group.The control group received full-course CAG pre-excitation therapy.Patients in the study group were also treated with desitabine combined with half-course preexcitation.Observe clinical efficacy,adverse reactions,record the recovery time of neutrophils and platelets,and observe the total survival time(OS)of patients.Results The remission rate(RR)and OS of the study group were 69.57%(16/23)and(12.75±0.92)months,respectively,which were 52.17%(12/23)and(10.80±0.86)months higher than the control group.Statistical significance(χ^2=8.650,t=9.800,P<0.05);the recovery time of neutrophils and platelets in the study group was(13.52±1.04)d and(14.16±1.12)d,respectively,which were lower than the control group(16.73±1.18)d and(17.08±1.20)d,the difference was statistically significant(t=9.930,10.140,P<0.05).There were no statistically significant differences in adverse reactions between the two groups(P>0.05).Conclusion The combination of decitabine and half-way pre-excitation in the treatment of elderly patients with AML has a significant clinical effect,which can prolong the survival of patients,shorten the recovery time of neutrophils and platelets,and is safer.