维奈克拉辅助DEA化疗方案对急性髓系白血病患者生存率及血清血管内皮生长因子、生存素水平的影响

Effect of Venetoclax Combined with DEA Chemotherapy on Survival Rate and Serum VEGF and Survivin Levels in Patients with Acute Myeloid Leukemia

目的探究维奈克拉辅助柔红霉素+依托泊苷+阿糖胞苷(DEA)化疗方案对急性髓系白血病患者的临床疗效。方法选取洛阳市第三人民医院2020年12月至2022年2月收治的72例急性髓系白血病患者,按照化疗方案不同分为常规组、试验组,各36例。常规组采用DEA化疗方案,试验组采用维奈克拉+DEA化疗方案。比较两组临床骨髓缓解率、血液指标、血清生存素、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)、γ干扰素(IFN-γ)、毒副反应及预后情况。结果试验组骨髓缓解总有效率(72.22%)高于常规组(47.22%)(P<0.05);治疗后试验组骨髓原始细胞比率低于常规组,血小板计数、白细胞计数高于常规组(P<0.05);治疗后试验组血清VEGF、生存素、TNF-α水平低于常规组,血清FN-γ水平高于常规组(P<0.05);两组毒副反应比较,差异无统计学意义(P>0.05);两组中位生存期比较,差异有统计学意义(P<0.05)。结论维奈克拉辅助DEA化疗方案可提高急性髓系白血病患者骨髓缓解率,降低血清VEGF、生存素表达,延长患者中位生存期。

Objective To explore the clinical efficacy of venetoclax combined with daunorubicin+etoposide+cytarabine(DEA)chemotherapy in patients with acute myeloid leukemia(AML).Methods A total of 72 patients with AML admitted to Luoyang Third People's Hospital from December 2020 to February 2022 were divided into conventional group and experimental group according to different chemotherapy regiments,with 36 cases in each group.The conventional group was treated with DEA chemotherapy,and the experimental group was treated with venetoclax+DEA chemotherapy.Clinical bone marrow response rate,blood indexes,serum survivin,tumor necrosis factor-α(TNF-α),vascular endothelial growth factor(VEGF),interferon gamma(IFN-γ),toxicity and prognosis were compared between the two groups.Results The total response rate of bone marrow remission in experimental group(72.22%)was higher than that in conventional group(47.22%)(P<0.05).After treatment,the bone marrow primitive cell ratio of experimental group was lower than that of conventional group,and the platelet count and white blood cell count were higher than that of conventional group(P<0.05).After treatment,serum VEGF,survivin and TNF-α levels in experimental group were lower than those in conventional group,and serum FN-γ levels were higher than those in conventional group(P<0.05).There was no significant difference in toxicity between the two groups(P>0.05).There was significant difference in median survival between the two groups(P<0.05).Conclusion Venetok-assisted DEA chemotherapy can improve the bone marrow response rate,reduce serum VEGF and survivin expression,and prolong the median survival of AML patients.