地西他滨联合高三尖杉酯碱、阿糖胞苷治疗复发性急性髓系白血病患者的效果

Effects of Decitabine combined with Homoharringtonine and Cytarabine in treatment of patients with recurrent acute myeloid leukemia

目的:观察地西他滨联合高三尖杉酯碱、阿糖胞苷治疗复发性急性髓系白血病患者的效果。方法:回顾性分析2017年2月至2023年2月该院收治的82例复发性急性髓系白血病患者的临床资料,根据治疗方法不同将其分为对照组(n=34)和观察组(n=48)。对照组给予高三尖杉脂碱联合阿糖胞苷治疗,观察组在对照组基础上联合地西他滨治疗。比较两组临床疗效,治疗前后血常规指标[血小板计数(PLT)、红细胞计数(RBC)、白细胞计数(WBC)、血红蛋白(Hb)、中性粒细胞计数(NEUT)]水平、WT1基因表达水平及不良反应发生率。结果:观察组客观缓解率为64.58%,高于对照组的29.41%,差异有统计学意义(P<0.05);治疗后,两组PLT、RBC、Hb、NEUT水平均高于治疗前,且观察组高于对照组,两组WBC水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组WT1基因表达水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组皮肤干燥、恶心呕吐、食欲减退等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:地西他滨联合高三尖杉酯碱、阿糖胞苷治疗复发性急性髓系白血病患者,可提高临床疗效,改善血常规指标水平,降低WT1基因表达水平,效果优于高三尖杉脂碱联合阿糖胞苷治疗。

Objective:To observe effects of Decitabine combined with Homoharringtonine and Cytarabine in treatment of patients with recurrent acute myeloid leukemia.Methods:The clinical data of 82 patients with recurrent acute myeloid leukemia admitted to this hospital from February 2017 to February 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group(n=34)and observation group(n=48).The control group was treated with Homoharringtonine combined with Cytarabine,while the observation group was treated with Decitabine on the basis of those of the control group.The clinical efficacy,the blood routine indicator levels[platelet count(PLT),red blood cell count(RBC),white blood cell count(WBC),hemoglobin(Hb),neutrophil count(NEUT)]before and after the treatment,the WT1 gene expression level,and the incidence of adverse reactions were compared between the two groups.Results:The total remission rate of the observation group was 64.58%,which was higher than 29.41%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of PLT,RBC,Hb and NEUT in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the WBC levels of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).The expression levels of WT1 gene in the two groups were lower than those before the treatment,that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions such as dry skin,nausea and vomiting,and decreased appetite between the two groups(P>0.05).Conclusions:Decitabine combined with Homoharringtonine and Cytarabine in the treatment of the patients with recurrent acute myeloid leukemia can improve the clinical efficacy,improve the levels of blood routine indicators and reduce the expression levels of WT1 gene.Moreover,it is superior to Homoharringtonine combined with Cytarabine treatment.