CAG及CAG联合地西他滨化疗方案治疗老年急性髓系白血病的疗效比较

目的 比较CAG及CAG联合地西他滨（DAC）化疗方案治疗老年急性髓系白血病(AML)的疗效。方法 回顾性分析我院诊治的老年AML患者76例，对采用CAG或CAG+DAC两种不同化疗方案做为诱导缓解方案的患者的临床疗效进行分析，分析两组在完全缓解率，总有效率，中位生存期，中位无复发生存期的差异。结果 在老年AML患者，CAG组49例，完全缓解率为51.0%，总有效率为61.2%， CAG+DAC组27例，分别为59.3%和77.8%，两者完全缓解率和总有效率差异无统计学意义(P>0.05)；在中位生存期（10.0个月 vs 12.0个月，P=0.225）和无复发生存期（8.0个月 vs 11.0个月，P=0.652）差异无统计学意义。但在高危组患者，CAG+DAC组完全缓解率，总有效率优于CAG组，分别为57.1% vs 15%；71.4% vs 25%，差异有统计学意义(P<0.05)。中位生存期6.0个月 vs 10.0个月及无复发生存期为4.0个月 vs 7.0个月(P>0.05)，CAG+DAC组均有延长趋势。 结论 CAG和CAG+DAC化疗方案临床疗效相当，但对预后差的老年AML患者，CAG+DAC在临床疗效方面显示出了优势。

Curative effect of CAG regimen compared with CAG combined with decitabine regimen in elderly patients with acute myeloid leukemia

Objective To compare the curative effect of CAG regimen and CAG combined with decitabine regimen in elderly patients with acute myeloid leukemia(AML). Methods Seventy six de novo elderly patients with AML who were diagnosed in our hospital were analyzed by a retrospective analysis. The 76 cases were divided into groups with CAG group and CAG+DAC group according to different chemotherapies. We compared the differences of complete remission rate， overall response rate， median overall survival and median relapse free survival in two groups. Results CAG group of 49 cases：CR rate was 51.0%， ORR was 61.2%; CAG+DAC group of 27 cases: CR rate was 59.3%， ORR was 77.8%. The statistics analysis showed no significant differences in CR rate and ORR between two groups(P>0.05). There were differences in median OS (10.0 months vs 12.0 months) and median RFS (8.0 months vs 11.0 months ) in two groups(P>0.05). But in the high risk group of patients， CR rate and ORR of the CAG+DAC group were higher than those of CAG group，respectively (57.1% vs 15%; 71.4% vs 25%)， the difference was statistically significant(P<0.05). CAG+DAC group was better than CAG group in median OS and median RFS， respectively (6.0 months vs 10.0 months) and (4.0 months vs 7.0 months)(P>0.05). Conclusion CAG regimen is similar with CAG+DAC regimen in the clinical curative effect， but CAG+DAC regimen is better in the elderly patients with AML with poor prognosis.