维奈克拉联合地西他滨或阿扎胞苷对高危骨髓增生异常综合征疗效的对比研究

Comparative study on the efficacy of Venetoclax combined with decitabine or azacytidine in patients with high-risk myelodysplastic syndrome

目的:比较维奈克拉(Venetoclax,VEN)分别联合阿扎胞苷(Azacitidine,AZA)与地西他滨(Decitabine,DAC)治疗高危骨髓增生异常综合征(Myelodysplastic syndrome,MDS)的疗效及安全性。方法:选取2021年12月至2023年12月期间于本院进行诊治的128例高危MDS患者作为研究对象。随机将患者分为VD组和VA组,各64例。两组患者均口服VEN进行治疗,在此基础上,VD组联合静脉滴注DAC,VA组联合皮下注射AZA。分析比较两组的临床疗效,血生化指标水平以及不良反应发生情况。结果:VA组的客观缓解率(Objective remission rate,ORR)明显高于VD组(P<0.05)。治疗2个疗程后,两组的白细胞(White blood cell,WBC)、血小板(Platelet count,PLT)、血红蛋白(Hemoglobin,Hb)水平以及生存质量评分均比治疗前明显升高,骨髓原始细胞比例(Non erythroid cell,NEC)均明显降低,且VA组的上述血生化指标明显高于VD组(P<0.05)。两组的不良反应总发生率无明显差异(P>0.05)。结论:与VEN联合DAC治疗相比,VEN联合AZA治疗能提高临床疗效,改善高危MDS患者的血生化指标,提高患者生存质量,且安全性较高。

Objective:To compare the efficacy and safety of venacla(ven)combined with azacytidine(AZA)and decitabine(DAC)in the treatment of high-risk myelodysplastic syndrome(MDS).Methods:One hundred and twenty-eight high-risk MDS patients who were treated in our hospital from December 2021 to December 2023 were selected as the study objects.Patients were randomly divided into VD group(n=64)and VA group(n=64).Both groups were given VEN orally,on the basis of which DAC was given intravenously in the VD group and AZA was given subcutaneously in the VA group.The clinical efficacy,blood biochemical indexes and the occurrence of adverse reactions were analyzed and compared between the two groups.Results:The objective response rate(ORR)of VA group was 84.38%,which was significantly higher than that of VD group(65.63%)(P<0.05).After 2 courses of treatment,the levels of WBC,PLT and Hb in 2 groups were significantly higher than before treatment,and the levels of NEC were significantly lower,and the changes of the above blood biochemical indexes in VA group were greater(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with VEN combined with DAC,VEN combined with AZA can improve the clinical efficacy,improve blood biochemical indexes of high-risk MDS patients,enhance their quality of life and has higher safety.