基于耐药基因检查结果选择化疗方案治疗难治或复发急性白血病的效果分析

Effect Analysis of Selection of Chemotherapy Regimens in Treatment of Refractory or Relapsed Acute Leukemia Based on Drug Resistance Gene Examination Results

目的:探讨基于耐药基因检查结果选择化疗方案治疗难治或复发急性白血病的临床效果。方法:选取2017年4月—2021年12月中国科学技术大学附属第一医院安徽省立医院收治的71例难治或复发急性白血病患者作为研究对象,所有患者化疗前均完成耐药基因检查,并根据检查结果选择合适的化疗方案。分析患者治疗效果、不良反应发生情况、生存期。结果:71例难治或复发急性白血病患者中完全缓解24例,部分缓解23例,不完全恢复24例,总缓解率71.83%。71例患者中,不同程度感染62例,占87.32%(62/71);粒细胞减少43例,占60.56%(43/71);经外周静脉穿刺中心静脉置管相关血栓9例,占12.67%(9/71);口腔黏膜溃疡20例,占28.17%(20/71)。脐血干细胞移植42例,移植患者生存率高于未移植患者,差异有统计学意义(P<0.05);治疗后缓解和未缓解患者生存率比较,差异无统计学意义(P>0.05)。结论:难治或复发急性白血病患者基于耐药基因检查结果选择化疗方案,能提高治疗效果,可延长患者生存期,具有较好的安全性。

Objective:To investigate the clinical effect of chemotherapy regimen selected based on the results of drug resistance gene examination in the treatment of refractory or relapsed acute leukemia.Methods:A total of 71 patients with refractory or relapsed acute leukemia admitted to The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from April 2017 to December 2021 were selected as study subjects.Before chemotherapy,all patients completed the drug resistance gene examination,and the appropriate chemotherapy regimen was selected according to the examination results.The treatment effect,adverse reaction and the survival period of patients were analyzed.Results:Among 71 patients with refractory or relapsed acute leukemia,28 patients had complete remission,23 patients had partial remission and 28 patients had incomplete recovery.The total response rate was 71.83%.Among 71 patients,62 patients had infection of varying degrees,accounting for 87.32%(62/71);43 patients had granulocytopenia,accounting for 60.56%(43/71);9 patients had peripherally inserted central catheter related thrombosis,accounting for 12.67%(9/71);and 20 patients had oral mucosal ulcer,accounting for 28.17%(20/71).42 patients received umbilical cord blood stem cell transplantation,and the survival rate of the transplanted patients was higher than that of the non-transplanted patients,with statistically significant difference(P<0.05).After treatment,there was no significant difference in the survival rate of patients with remission and without remission(P>0.05).Conclusion:Chemotherapy regimen selected based on the results of drug resistance gene examination for patients with refractory or relapsed acute leukemia can improve the treatment effect,prolong the survival period of patients,and have high safety.