以地西他滨为主方案治疗初发老年人急性髓系白血病近期疗效分析

目的 探讨以地西他滨为主方案治疗初发老年人急性髓系白血病(AML)的临床安全性和有效性.方法 选择2014年6月至2015年12月首都医科大学附属北京潞河医院收治的12例初发老年AML患者,应用地西他滨单药或联合低剂量化疗方案治疗,对12例患者临床资料进行回顾性分析.结果 12例患者中1个疗程达完全缓解(CR)者6例,部分缓解(PR)者5例,未缓解(NR)者1例.6例CR患者中1例在第6个疗程后复发,其余在随访中仍CR;5例PR患者中2例经2个疗程化疗后达CR,1例在第2个疗程化疗后复发,2例在第3个疗程化疗后复发.1例患者经2个疗程化疗后NR,因肺部感染死亡.4例复杂核型患者中3例疗效差,1例达CR,但最终仍复发;其余8例+8、-X或正常核型患者中7例短期达CR.主要不良反应为骨髓抑制和感染,所有患者均能耐受.结论 地西他滨单药或联合低剂量化疗方案治疗初发老年人AML近期疗效好,耐受性好,安全性高,可作为一线治疗方案.

Efficacy analysis of decitabine based regimen for treatment of elderly patients with acute myeloid leukemia

Objective To investigate the security and efficacy in the elderly patients with acute myeloid leukemia (AML) treated by decitabine based regimen. Methods A retrospective analysis was carried out on 12 elderly patients with AML who were treated by decitabine alone or with low-dose chemotherapy in Beijing Luhe Hospital, Capital Medical University from June 2014 to December 2015. Results There were 6 patients of complete remission (CR), 5 patients of partial remission (PR), 1 patient of none remission (NR) after one course of chemotherapy. 1 case of 6 CR patients relapsed after 6 cycles of chemotherapy , others remained CR during the follow-up . Among 5 PR patients , 2 cases achieved CR , 1 patient relapsed after 2 cycles of chemotherapy and 2 patients relapsed after 3 cycles of chemotherapy. 1 patient remained NR after 2 cycles of chemotherapy and died of severe pulmonary infection. 3 of 4 complex karyotype patients had poor efficiency, and only 1 patient achieved CR but relapsed eventually. 7 patients achieved CR in patients with +8, -X or normal karyotype in the near future. The main adverse effects were bone marrow suppression and infection. All patients could tolerate. Conclusion Elderly patients with primary AML treated by decitabine alone or with low-dose chemotherapy show good effects, well tolerance and high safety, which could serve as the front-line treatment.