地西他滨联合CHG方案治疗老年急性髓系白血病的疗效分析

目的分析地西他滨联合CHG方案治疗老年急性髓系白血病的有效率和不良反应。方法将郑州市第三人民医院2015年1月至2019年1月收治的62例老年急性髓系白血病患者作为观察对象,根据治疗方法不同分为观察组和对照组,每组31例。观察组行地西他滨(20 mg/m2,连续服用5 d)联合CHG治疗(阿糖胞苷,20 mg/m2, 12h/次,皮下注射2周;高三尖杉酯,HHT 1 mg/m2,静脉滴注2周;重组人粒细胞集落刺激因子300μg/d)。对照组行HA治疗(阿糖胞苷,20 mg/m2, 12h/次,皮下注射2周;高三尖杉酯,HHT 1 mg/m2,静脉滴注2周)。比较两组治疗后治疗有效率、不良反应及血制品输注、随访18个月的生存率。结果观察组治疗有效率为96.77%(30/31),对照组为77.42%(24/31),差异有统计学意义(P<0.05)。观察组粒细胞缺乏时间、PLT<20×109/L时间、红细胞输注量、血小板输注量均低于对照组,差异有统计学意义(P<0.05),两组患者感染、出血等不良反应情况差异未见统计学意义(P>0.05)。采用log rank检验对两组生存曲线进行比较的结果显示,两组生存率差异有统计学意义(P<0.05)。结论地西他滨联合CHG方案治疗老年急性髓系白血病有效率较高,不良反应少,且随访18个月后的生存率较高,值得借鉴。

Curative effect of decitabine combined with CHG regimen on elderly patients with acute myeloid leukemia

Objective To analyze the effective rate and side effects of decitabine combined with CHG regimen in the treatment of elderly acute myeloid leukemia. Methods Sixty-two elderly patients with acute myeloid leukemia admitted to the Third People’s Hospital of Zhengzhou from January 2015 to January 2019 were taken as observation objects. According to different treatment methods, they were divided into observation group and control group, with 31 cases in each group. Observation group received decitabine(20 mg/m2, continuous taking for 5 days) combined with CHG treatment(cytarabine, 20 mg/m2, 12 h/time, subcutaneous injection for 2 weeks;homoharringtonine, HHT 1 mg/m2, intravenous infusion for 2 weeks;recombinant human granulocyte colony stimulating factor 300 μg/d). The control group received HA treatment(cytarabine, 20 mg/m2, 12 h/time, subcutaneous injection for 2 weeks;homoharringtonine, HHT 1 mg/m2, intravenous infusion for 2 weeks). After treatment, the survival rates of the two groups were compared, including the effective rate, adverse reactions, blood product infusion, and follow-up at 18 months. Results The effective rate of treatment in the observation group was 96.77%(30/31), and that of the control group was 77.42%(24/31), the difference was significant(P<0.05). In the observation group, the granulocyte deficiency time, PLT<20×109/L time, red blood cell infusion volume and platelet transfusion volume were all lower than those in the control group, and the differences were significant(P<0.05). There was no significant difference in adverse reactions, such as infection and bleeding, between the two groups(P>0.05). The log rank test was used to compare the survival curves of the two groups, and the difference in survival rate between the two groups was significant(P<0.05).Conclusions Decitabine combined with CHG regimen is more effective on elderly acute myeloid leukemia, with fewer adverse reactions, and a higher survival rate after 18 months of follow-up, which is worth learning.