不同化疗方案治疗MDS-RAEB/AML-MRC临床对比研究

目的:探讨常规CAG方案与地西他滨+减量CAG方案对骨髓增生异常综合征伴原始细胞增多(MDS-RAEB)/急性髓系白血病伴骨髓增生异常相关改变(AML-MRC)患者疗效及安全性的影响。方法:回顾性分析于2012年3月-2017年7月本院收治的67例MDS-RAEB/AML-MRC患者的临床资料。67例中采用常规CAG方案治疗37例设为对照组,采用地西他滨+减量CAG方案治疗30例设为D+dCAG组,比较2组患者的完全缓解(CR)率、总缓解率(ORR)、总生存时间(OS)、无进展生存时间(PFS)及不良反应的发生率。结果:D+dCAG组CR率显著高于对照组(P<0.05);2组ORR比较差异无显著性(P>0.05);2组累积OS率比较差异无显著性(P>0.05);2组非移植的累积OS率和PFS率比较差异无显著性(P>0.05);2组血液系统不良反应、肺部感染、皮肤软组织感染、粒细胞缺乏期发热及真菌感染发生率比较差异无显著性(P>0.05);2组粒细胞缺乏持续时间和血小板计数小于20×10^9/L持续时间比较差异无显著性(P>0.05)。结论:相较于常规CAG方案,地西他滨+减量CAG方案治疗MDS-RAEB/AML-MRC在改善疾病缓解效果方面具有优势,总体安全性良好,但仍未提高患者的生存率。

Clinical Comparation of Two Kinds of Chemotherapy Regimens in the Treatment of Patients with MDS-RAEB/AML-MRC

Objective:To investigate the influence of conventional CAG regimen and decitabine+decreased dose CAG(D+dCAG)regimen on the clinical efficacy and safety of patients with MDS-RAEB/AML-MRC.Methods:The clinical data of 67 patients with MDS-RAEB/AML-MRC hospitalized in our hospital from March 2012 to July 2017 were analyzed retrospectively.According to chemotherapecctic regimens,76 patients were divided into 2 groups:37 patients treated with conventional CAG regimen were enrolled in control group,30 patients treated with decitabine+decreased dose CAG regimen were enrolled in D+dCAG group.The complete remission(CR)rate,overall remission rate(ORR),OS and PFS time and incidence of adverse reactions in 2 groups were compared.Results:The CR in D+dCAG group was significantly higher than that in control group(P<0.05).ORR was not significanly different between 2 groups(P>0.05).There was no significant difference in the cumulative OS rate between 2 groups(P>0.05).There was no significant difference in the cumulative OS rate and PFS rate in nonimplantation between 2 groups(P>0.05).The incidence of adverse reactions of hematological system,pulmonary infection,skin and soft tissue infection,agranulocytosic fever and mycotic infection was not significanly different between 2 groups(P>0.05).The duration of granulocyte deficiency and platelet count less than 20×10^9/L were not significanly different between 2 groups(P>0.05).Conclusion:Compared with conventional CAG regimen,decitabine+decreased dose CAG regimen in the treatment of patients with MDSRAEB/AML-MRC can efficiently improve the remission effects and showed the well overall safety,but can not increase the survival rate.