地西他滨联合半量CAG和单用CAG方案治疗老年人急性髓系白血病效果比较

目的 探讨地西他滨联合半量CAG方案和单用CAG方案治疗老年人急性髓系白血病(AML)的疗效及不良反应.方法 回顾性分析山东省菏泽市立医院2013年8月至2017年8月收治的42例老年AML患者(急性早幼粒细胞白血病除外)临床资料,患者年龄65～75岁.根据化疗方案分为治疗组和对照组,治疗组20例采用地西他滨联合半量CAG方案(重组粒细胞集落刺激因子+阿糖胞苷+阿柔比星),对照组22例单用CAG方案.结果 1个疗程后治疗组患者完全缓解(CR) 13例,部分缓解(PR)3例,未缓解(NR)4例,总有效(CR+PR)率为80.0％(16/20);对照组CR 8例,PR 2例,NR 12例,总有效率为45.5％(10/22),两组总有效率比较差异有统计学意义(x2=3.707,P=0.035).两组骨髓恢复时间、输注红细胞及血小板量比较,差异均无统计学意义(均P＞ 0.05).结论 地西他滨联合半量CAG方案治疗老年AML患者的效果优于单用CAG方案,不良反应均可耐受,可作为老年人AML的首选治疗方案.

Comparison of therapeutic efficacy between CAG regimen and decitabine combined with half dose CAG regimen in treatment of elderly patients with acute myeloid leukemia

Objective To explore the therapeutic efficacy and adverse effects of decitabine combined with half dose CAG regimen and only CAG regimen for the elderly patients with acute myeloid leukemia (AML).Methods A total of 42 elderly patients with AML aged between 65 and 75 years old (except for acute promyelocytic leukemia) admitted into Heze Municipal Hospital from August 2013 to August 2017 were retrospectively analyzed.They were divided into treatment group and control group according to the different chemotherapy regimens.Twenty patients in the treatment group were treated with decitabine combined with half dose CAG regimen (recombinant granulocyte colony stimulating factor + cytarabine + aclarubicin),and 22 patients in the control group were treated with CAG regimen.Results After the first course of treatment,in treatment group,13 cases achieved complete remission (CR),3 cases achieved partial remission (PR),4 cases achieved non-remission (NR),and the total efficacy (CR+PR) rate was 80.0 ％ (16/20).In control group,8 cases (36 ％) achieved CR,2 cases achieved PR,12 cases achieved NR,and the total efficacy rate was 45.5 ％ (10/22).The difference in total effective rate between the two groups was statistically significant (x2 =3.707,P =0.035).There was no significant difference in the bone marrow recovery time,the infusion of red blood cells and platelets between the two groups (all P ＞ 0.05).Conclusion The therapeutic efficacy of decitabine combined with half dose CAG regimen is better than that of CAG regimen,the adverse effects are all tolerated,and it can be served as the prior therapy for elderly AML patients.