地西他滨联合小剂量高三尖杉酯碱和阿糖胞苷治疗老年急性髓系白血病疗效观察

Effect of decitabine combined with low-dose homoharringtonine and cytarabine in the treatment of elderly patients with acute myeloid leukemia

目的探讨地西他滨联合小剂量高三尖杉酯碱和阿糖胞苷治疗老年急性髓系白血病(AML)的临床效果。方法选择2017年4月至2019年10月新乡市中心医院收治的94例老年AML患者为研究对象,根据治疗方法将患者分为观察组(n=43)和对照组(n=51)。观察组患者给予地西他滨联合小剂量高三尖杉酯碱和阿糖胞苷治疗,对照组患者给予柔红霉素联合阿糖胞苷治疗,2组患者均以7 d为1个疗程,共治疗2个疗程。2组患者治疗1个月后评估临床疗效,并观察治疗期间不良反应发生情况;分别于治疗前及治疗后1个月检测患者白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)和血红蛋白(HGB)水平。结果观察组和对照组患者总有效率分别为93.02%(40/43)、76.47%(39/51);观察组患者总有效率显著高于对照组(P<0.05)。治疗前2组患者WBC、RBC、PLT和HGB水平比较差异无统计学意义(P>0.05),2组患者治疗1个月后WBC、RBC、PLT和HGB水平显著高于治疗前(P<0.05);治疗后1个月,观察组患者WBC、RBC、PLT和HGB水平显著高于对照组(P<0.05)。观察组患者贫血性心脏病、重症肺部感染、消化道出血发生率分别为34.88%(15/43)、18.60%(8/43)、13.95%(6/43),对照组患者贫血性心脏病、重症肺部感染、消化道出血发生率分别为68.63%(35/51)、54.90%(28/51)、33.33%(17/51);观察组患者贫血性心脏病、重症肺部感染、消化道出血发生率显著低于对照组(P<0.05)。结论地西他滨联合小剂量高三尖杉酯碱和阿糖胞苷治疗老年AML疗效较好,且不良反应发生率低。

Objective To investigate the clinical effect of decitabine combined with low-dose homoharringtonine and cytarabine in the treatment of elderly patients with acute myeloid leukemia(AML).Methods A total of 94 elderly patients with AML admitted to Xinxiang Central Hospital from April 2017 to October 2019 were selected as the research subjects,and the patients were divided into observation group(n=43)and control group(n=51)according to the treatment methods.The patients in the observation group were treated with decitabine combined with low-dose homoharringtonine and cytarabine,while the patients in the control group were given daunorubicin combined with cytarabine,and the patients were treated for two course of treatment(7 days were a course of treatment).The clinical effect was evaluated at one month after treatment,and the incidence of adverse reactions during the treatment were observed.The white blood cell count(WBC),red blood cell count(RBC),platelet count(PLT)and hemoglobin(HGB)levels were detected before and one month after treatment.Results The total effective rates in the observation group and the control group were 93.02%(40/43)and 76.47%(39/51),respectively.The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in WBC,RBC,PLT and HGB levels between the two groups before treatment(P>0.05).The levels of WBC,RBC,PLT and HGB at one month after treatment were significantly higher than those before treatment in the two groups(P<0.05).The levels of WBC,RBC,PLT and HGB in the observation group were significantly higher than those in the control group at one month after treatment(P<0.05).The incidence rates of anemic heart disease,severe pulmonary infection and gastrointestinal bleeding in the observation group were 34.88%(15/43),18.60%(8/43)and 13.95%(6/43),respectively.The incidence rates of anemic heart disease,severe pulmonary infection and gastrointestinal bleeding in the control group were 68.63%(35/51),54.90%(28/51)and 33.33%(17/51),respectively.The incidence rates of anemic heart disease,severe pulmonary infection and gastrointestinal bleeding in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Decitabine combined with low-dose homoharringtonine and cytarabine is effective in the treatment of elderly AML,and the incidence of adverse reactions is low.