去甲基化药物联合CAG方案对老年白血病或难治复发性白血病疗效分析

Analysis of the Efficacy of Demethylation Drugs Combined with CAG Regimen on Elderly Leukemia or Refractory Relapsed Leukemia

目的探讨去甲基化药物联合CAG方案(阿糖胞苷+阿克拉霉素+粒细胞集落刺激因子)对老年白血病或难治复发性白血病的疗效。方法选取该院在2018年6月-2019年9月期间收治的86例老年白血病、难治复发性白血病患者参与该次研究,根据数字表法将其随机划分入观察组[去甲基化药物(地西他滨)联合CAG方案治疗]和对照组(CAG方案治疗),每组43例。就两组患者临床缓解总有效率、不良反应发生率、一年内复发率,开展治疗前和治疗后血清蛋白(Hb)水平、白细胞计数(WBC)和血小板计数(Plt)等指标进行分析比较。结果相较于对照组临床缓解总有效率(58.14%),观察组患者临床缓解总有效率(83.72%)更高,不良反应发生率(11.63%)和一年内复发率(6.98%)相较于对照组不良反应发生率(32.56%)和一年内复发率(25.58%)更低,差异有统计学意义(χ^(2)=6.824、5.472、5.460,P<0.05);治疗前观察组患者Hb水平(75.16±3.28)g/L,WBC和Plt水平(25.38±0.25)×10^(9)/L、(65.26±2.33)×10^(9)/L,与对照组Hb水平(75.09±3.12)g/L,WBC和Plt水平(25.35±0.29)×10^(9)/L、(65.34±2.29)×10^(9)/L差异无统计学意义(t=0.101、0.514、0.161,P>0.05),经过治疗,观察组Hb水平(93.25±2.47)g/L相比对照组患者Hb水平(82.65±2.38)g/L更高,WBC水平(5.94±1.37)×10^(9)/L相比对照组WBC水平(13.72±1.14)×10^(9)/L更低,Plt水平(188.47±10.25)×10^(9)/L相比对照组Plt水平(95.73±12.58)×10^(9)/L更高,差异有统计学意义(t=20.265、28.625、37.477,P<0.05)。结论去甲基化药物联合CAG方案对老年白血病或难治复发性白血病患者病情控制效果相比单纯CAG方案更理想,也具有更高的治疗安全性,故可在临床中推广。

Objective To explore the efficacy of demethylation drugs combined with CAG(cytarabine+aclarithromycin+granulocyte colony stimulating factor)on elderly leukemia or refractory relapsed leukemia.Methods A total of 86 elderly patients with leukemia and refractory relapsed leukemia admitted to the hospital from June 2018 to September 2019 were selected to participate in this study,and they were randomly divided into the observation group[demethylation drugs(decitabine)combined with CAG regimen treatment]and control group(CAG regimen treatment)according to the number table method.43 cases in each group.The total effective rate of clinical remission,incidence of adverse reactions,recurrence rate within one year,serum protein(Hb)levels before and after treatment,white blood cell count(WBC)and platelet count(Plt)were analyzed and compared between the two groups of patients.Results Compared with the total effective rate of clinical remission in the control group(58.14%),the total effective rate of clinical remission in the observation group(83.72%)was higher,and the incidence of adverse reactions(11.63%)was comparable to the recurrence rate within one year(6.98%).Compared with the control group,the incidence of adverse reactions(32.56%)and the recurrence rate within one year(25.58%)were lower,the difference was statistically significant(χ^(2)=6.824,5.472,5.460,P<0.05);the Hb level of the observation group before treatment(75.16±3.28)g/L,WBC and Plt levels(25.38±0.25)×10^(9)/L,(65.26±2.33)×10^(9)/L,Hb level(75.09±3.12)g/L,WBC and Plt levels(25.35±0.29)×10^(9)/L,(65.34±2.29)×10^(9)/L,with no statistically significant difference(t=0.101,0.514,0.161,P>0.05).After treatment,the Hb level of the observation group(93.25±2.47)g/L was higher than that of the control group(82.65±2.38)g/L,WBC level(5.94±1.37)×10^(9)/L compared to the control group WBC level(13.72±1.14)×10^(9)/L was lower,Plt level(188.47±10.25)×10^(9)/L compared to the control group Plt level(95.73±12.58)×10^(9)/L was higher,the difference was statistically significant(t=20.265,28.625,37.477,P<0.05).Conclusion Demethylation drugs combined with CAG regimen has better disease control effects in elderly leukemia or refractory relapsed leukemia patients than the CAG regimen alone.It also has higher treatment safety,so it can be promoted in the clinic.