地西他滨联合小剂量IA方案治疗骨髓增生异常综合征伴原始细胞增多的临床观察.docVIP

地西他滨联合小剂量IA方案治疗骨髓增生异常综合征伴原始细胞增多的临床观察 吴迪 郝锦霞 李静 张梅 西安交通大学第一附属医院血液内科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的:观察地西他滨联合小剂量去甲氧柔红霉素、阿糖胞苷 (DAC+IA) 方案治疗骨髓增生异常综合征伴原始细胞增多的临床疗效。方法:回顾性分析2015年6月-2017年1月在西安交通大学第一附属医院血液科治疗的37例骨髓增生异常综合征伴原始细胞增多患者, 分别采用DAC+IA方案 (19例) 和单用DAC (18例) 方案治疗, 观察其临床疗效和不良反应。结果:1-2疗程后, DAC+IA组CR+CRi率为57.9%, 总反应率100%, 骨髓病理组织幼稚细胞明显减少, 外周血中性粒细胞、血红蛋白、血小板水平显著提高, 完全缓解中位持续时间7.3月, 无进展生存时间为10月, 3例患者缓解后停止治疗, 3.5月复发。DAC组CR+CRi率为16.7%, 总反应率38.9%, 中位无进展生存时间为6月。3例患者达到完全缓解, 中位时间4个月均进展为AML。两组患者常见的不良反应为骨髓抑制和感染, 其差异无统计学意义。结论:DAC联合小剂量IA方案治疗骨髓增生异常综合征伴原始细胞增多, 可延长患者生存期, 改善生存质量, 近期疗效显著, 但远期疗效仍有待于异基因造血干细胞移植进行巩固。 关键词： 地西他滨; 骨髓增生异常综合征; 去甲基化; 化疗; 作者简介：张梅, 主任医师.E-mail:zhangmei@ 收稿日期：2017-06-24 Clinical Observation of Therapeutic Regimen Consisted of Decitabine Combined with Low-Dose IA Regimen for Myelodysplastic Syndrome-EB WU Di HAO Jin-Xia LI Jing ZHANG Mei Department of Hematology, The First Affiliated Hospital of Xian Jiaotong University; Abstract： Objective: To investigate the clinical efficacy of decitabine combined with low-dose IA for treating patients with myelodysplastic syndrome-EB. Methods: Thirty-seven cases of myelodysplastic syndrome-EB patients diagnosed in the First Affiliated Hospital of Xian Jiaotong University from June 2015 to January 2017 were analyzed retrospectively. These patients accepted DAC + IA ( 19 cases) and DAC ( 18 cases) treatment separately, and the differences of clinical efficacy between them were compared. Results: After 1-2 treatment cycles, in DAC + IA group the rate of complete remission with full hematologic recovery and incomplete hematologic recovery was 57. 9%, and overall response rate was 100%. Immature cells level observed in bone marrow pathology was significantly decreased, compared with level before treatment. Peripheral blood neutrophil count, hemoglobin level and platelet count increased significantly. The median duration of the complete remission was 7. 3 months. The progression