地西他滨联合低剂量CAG方案化疗对老年急性髓系白血病的疗效与预后分析

Analysis of curative effect and prognosis of decitabine combined with low-dose CAG chemotherapy in elderly patients with acute myeloid leukemia

目的:探讨地西他滨联合低剂量CAG(阿糖胞苷+阿柔比星+粒细胞刺激因子)对老年急性髓系白血病(AML)的影响。方法:采用前瞻性研究方法,以我院2017年10月–2020年3月收治的100例老年AML患者为研究对象,按照随机数字表法分为对照组(50例)和观察组(50例)。对照组给予地西他滨联合标准剂量CAG治疗,观察组给予地西他滨联合低剂量CAG治疗。对比分析两组血液指标、血清免疫指标、治疗效果、不良反应及预后情况。结果:治疗后,观察组患者血红蛋白含量显著高于对照组(P<0.05);观察组患者血清CD4^(+)和CD8^(+)细胞数量显著低于对照组(P<0.05);观察组患者各项不良反应发生率均低于对照组,其中血小板减少发生率与对照组相比差异具有统计学意义(P<0.05)。随访18个月后,观察组患者的总生存率高于对照组(P<0.05)。结论:地西他滨联合低剂量CAG治疗老年AML疗效较好,不良反应发生率低,患者预后较好。

Objective:To investigate the effect of decitabine combined with low-dose CAG chemotherapy(cytosine arabinoside + aclarubicin + granulocyte stimulating factor)in elderly patients with acute myeloid leukemia(AML).Methods:A prospective study was conducted in a total of 100 elderly patients with AML from October 2017 to March 2020 in our hospital.All the patients were randomly divided into the control group(n=50)and the observation group(n=50)according to the random number table.The control group was given decitabine combined with standard CAG chemotherapy while the observation group was given decitabine combined with low-dose CAG chemotherapy.The blood indexes,serum immune indexes,curative effect,adverse drug reaction(ADR)and prognosis of the two groups were compared.Results:After treatment,the hemoglobin content of the observation group was significantly higher than that of the control group(P<0.05).Meanwhile,the number of CD4^(+)and CD8^(+)cells in the observation group was significantly lower than those in the control group(P<0.05).The incidence of various ADRs in the observation group was lower than that in the control group,and the incidence of thrombocytopenia was significantly lower than that in the control group(P<0.05).After 18 months of follow-up,the overall survival rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Decitabine combined with low-dose CAG chemotherapy in elderly patients with AML showed good curative effect with low incidence of ADR and a good prognosis.