中剂量阿糖胞苷巩固强化治疗老年AML患者疗效和安全性

Efficacy and Safety of Medium-dose Cytarabine Intensive Treatment in Elderly Patients with AML

目的观察中剂量阿糖胞苷巩固强化治疗在初治老年急性髓系白血病(AML)患者的临床疗效和不良反应。方法回顾性分析2012年10月~2017年2月在我院诊治的2个疗程内达完全缓解(CR)的初治老年AML(非APL)患者58例,将应用中剂量阿糖胞苷进行巩固强化治疗的33例设为中剂量阿糖胞苷组,应用标准剂量阿糖胞苷进行巩固强化治疗的25例设为标准剂量阿糖胞苷组,比较两组总生存(OS)时间、无复发生存(RFS)时间、3年生存率、累积复发率及不良反应发生情况。结果中剂量阿糖胞苷组OS时间长于标准剂量阿糖胞苷组[(47.15±17.46)个月vs(21.76±11.24)个月](P=0.000);中剂量阿糖胞苷组RFS时间长于标准剂量阿糖胞苷组[(44.82±17.15)个月vs(18.88±10.28)个月](P=0.000);中剂量阿糖胞苷组和标准剂量阿糖胞苷组3年生存率分别为30.30%(10/33)和16.00%(4/25),两组比较,差异无统计学意义(P=0.207);两组累积复发率分别为24.24%(8/33)和56.00%(14/25)(P=0.014)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论应用中剂量阿糖胞苷巩固强化治疗初治CR老年AML患者,有助于延长患者的OS、RFS时间,降低患者的累计复发率,不良反应发生率低。

Objective To observe the clinical efficacy and adverse reactions of medium-dose cytarabine consolidation and intensive therapy in newly treated elderly patients with acute myeloid leukemia(AML).Methods A retrospective analysis of 58 newly treated elderly AML(non-APL)patients who achieved complete remission(CR)within two courses of treatment in our hospital from October 2012 to February 2017,will be consolidated with medium-dose cytarabine 33 cases of intensive treatment were set in the medium-dose cytarabine group,and 25 cases of standard-dose cytarabine for consolidation and intensive treatment were set in the standard-dose cytarabine group.The total survival(OS)time,recurrence-free survival(RFS)time,3-year survival rate,cumulative recurrence rate,and adverse events were compared between the two groups.Results The OS time in the medium-dose cytarabine group was longer than that in the standard-dose cytarabine group[(47.15±17.46)months vs(21.76±11.24)months](P=0.000);The RFS time in the cytidine group was longer than that in the standard-dose cytarabine group[(44.82±17.15)months vs(18.88±10.28)months](P=0.000);the medium-dose cytarabine group and The 3-year survival rates of the standard-dose cytarabine group were 30.30%(10/33)and 16.00%(4/25).There was no significant difference between the two groups(P=0.207);The cumulative recurrence rates in the two groups were 24.24%(8/33)and 56.00%(14/25)(P=0.014).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of medium-dose cytarabine to strengthen and strengthen the treatment of elderly CR patients with AML can help prolong the OS and RFS time of patients,reduce the cumulative recurrence rate of patients,and reduce the incidence of adverse reactions.