低剂量地西他滨联合减量HAG方案治疗老年低增生急性髓系白血病疗效观察

目的:观察低剂量地西他滨联合减量HAG方案（HHT、Ara-C、G-CSF)诱导治疗老年低增生急性髓系白血病的疗效及安全性。方法:对我院2015年1月至2018年1月收治的46例初诊的老年低增生急性髓系白血病患者进行回顾性分析，应用低剂量地西他滨联合减量HAG方案诱导化疗，观察疗效并评价其安全性。结果:46例患者均完成2个疗程治疗，骨髓造血恢复后复查骨髓象评估疗效。其中完全缓解(complete remission，CR) 20例(43.5%)，部分缓解(partial remission，PR)9例(19.6%)，总有效率(overall remission rate，ORR)为63.0%(29/46)。46例患者均出现Ⅲ-Ⅳ级血液学毒性、粒细胞减少引起的感染及血小板减少引起的出血为主的合并症。恶心呕吐、肝肾功损害、心脏毒性等非血液学毒性均可耐受，均无治疗相关死亡病例。性别、年龄、KPS评分对完全缓解率无明确影响(P＞0.05)。正常细胞遗传学患者较不良细胞遗传学患者缓解率高，具有统计学差异(P＜0.05)。结论:低剂量地西他滨联合减剂量 HAG方案治疗老年低增生急性髓系白血病疗效确切，缓解率较高，毒副反应可安全耐受。

Therapeutic effect of low-dose decitabine combined with reduced HAG regimen in the treatment of elderly patients with hypoproliferative acute myeloid leukemia

Objective:To observe the efficacy and safety of low-dose decitabine combined with reduced HAG regimen（HHT,Ara-C,G-CSF) in the treatment of elderly patients with proliferative acute myeloid leukemia.Methods:A retrospective analysis of 46 patients with newly diagnosed hypoproliferative acute myeloid leukemia admitted to our hospital from January 2015 to January 2018 were induced by low-dose decitabine combined with reduced HAG regimen,to observe the efficacy and evaluate its safety.Results:All 46 patients completed 2 courses of chemotherapy,and the bone marrow was evaluated after the recovery of hematopoiesis.Among them,complete remission（CR) was performed in 20 cases（43.5%).Partial remission（PR) was 19.6%（9 cases),and total remission rate（ORR) was 63.0%（29/46).All patients developed grade Ⅲ-Ⅳ hematologic toxicity.The main complications were infection caused by neutropenia and bleeding caused by thrombocytopenia.Non-hematologic toxicity such as nausea and vomiting,liver and kidney damage,and cardiotoxicity can be tolerated without treatment-related death.Gender,age,and KPS scores had no significant effect on complete remission rate(P＞0.05).Patients with normal cytogenetics had higher remission rate than those with poor cytogenetics,and the difference was statistically significant（P＜0.05).Conclusion:Low-dose decitabine combined with reduced-dose HAG regimen is effective in the treatment of elderly patients with hypoproliferative acute myeloid leukemia.The remission rate is high and the adverse reactions can be tolerated.