阿米福汀对骨髓增生异常综合征患者红细胞寿命的影响

Effect of Amifostine on the Life Span of Red Blood Cells in Patients with Myelodysplastic Syndrome

目的研究骨髓增生异常综合征(myelodysplastic syndrome,MDS)患者的红细胞寿命以及阿米福汀对红细胞寿命的影响。方法回顾性分析浙江省中医院血液科2017年1月-2018年7月期间81例MDS患者的临床资料,分为阿米福汀治疗组(49例)和支持治疗组(32例)。以同期9名正常志愿者为正常对照,采用内源性一氧化碳呼气试验法测定患者及志愿者的红细胞寿命,分析MDS患者红细胞寿命及阿米福汀对红细胞寿命的影响。结果 81例初发MDS患者(未经输血支持)平均红细胞寿命为(33.41±10.96)d,与正常对照红细胞寿命(121.11±32.59)d相比明显缩短(P<0.01)。阿米福汀治疗组:部分缓解1例,血液学改善13例,疾病稳定12例,总有效率53.1%。治疗后MDS患者的红细胞寿命(42.24±12.99)d,与治疗前相比明显延长(P<0.01)。支持治疗组:血液学改善2例,疾病稳定9例,总有效率34.4%,红细胞寿命(34.53±7.50)d,与治疗前相比未明显改善。红细胞寿命与疗效关系分析表明,血液学改善患者的红细胞寿命(45.92±9.24)d,较正常对照组红细胞寿命短(P<0.01),与治疗前比较明显延长(P<0.01)。其余患者红细胞寿命治疗前后无统计学意义。结论 MDS患者红细胞寿命缩短,阿米福汀治疗后可提高患者红细胞寿命。

OBJECTIVE To explore the life span of red blood cell(RBC) in patients with myelodysplastic syndrome(MDS) and the effect of amifostine on the life span of RBC.METHODS Retrospective analysis of clinical data of 81 patients with MDS from January 2017 to July 2018 in department of hematology in Zhejiang Provincial Hospital of TCM,divided into amifostine treatment group(49 cases) and supportive treatment group(32 cases).In the same period,9 healthy volunteers were used as normal controls.The endogenous Breath Carbon Monoxide(CO) test was used to measure the life span of RBC in patients and volunteers.The life span of RBC in patients with MDS and the effect of amifostine on life span of RBC were explored.RESULTS The mean life span of RBC of 81 patients with initial MDS(no blood transfusion support) was(33.41±10.96)d,which was significantly shorter than that in the normal control group(121.11±32.59)d(P<0.01).In the amifostine treatment group,one case achieved partial remission,13 cases achieved hematologic improvement(HI),12 cases achieved stable disease(SD),the overall response(ORR) was 53.1%.The life span of RBC in patients with MDS after treatment was(42.24±12.99)d,which was significantly longer than that before treatment(P<0.01).In the supportive treatment group,2 cases achieved HI,and 9 cases achieved SD,the ORR was 34.4%,and the life span of RBC was(34.53±7.50)d,which was not significantly improved compared with before treatment.Statistical analysis of the efficacy of treatment showed that,the HI patients with the life span of RBC was(45.92±9.24)d.It was significantly shorter than the normal control group(P<0.01),and it was significantly longer than before treatment(P<0.01).There was no statistical significance of RBC life span in other patients before and after treatment.CONCLUSION The life span of RBC is shortened in patients with MDS,which can be improved after treatment with amifostine.