地西他滨联合CAG方案治疗高危骨髓增生异常综合征疗效观察

目的探讨地西他滨联合CAG方案治疗高危骨髓增生异常综合征的临床价值。方法高危骨髓增生异常综合征患者80例随机分成2组:对照组40例采用CAG(阿糖胞苷+阿柔比星+粒细胞集落刺激因子)方案治疗;观察组40例采用地西他滨联合CAG方案治疗。治疗6个疗程后观察比较2组的近期疗效、生存期、血管内皮生长因子(VEGF)水平及不良反应。结果观察组的总有效率显著高于对照组(77.5%vs 55.0%,P<0.05),总体生存期、无病生存期均显著性长于对照组分别为(32.50±21.64)月vs(24.07±15.23)月和(26.88±17.02)月vs(20.11±10.45)月,P<0.05];与治疗前比较,2组治疗后1 d、3 d、7 d、14 d的VEGF水平均显著降低(P<0.05),且观察组低于对照组(P<0.05);2组的主要不良反应为Ⅰ～Ⅱ级骨髓抑制、肺部感染,经处理患者可耐受。结论地西他滨联合CAG方案治疗高危骨髓增生异常综合征安全可靠。

Clinical study on decitabine combined with CAG regimen in the treatment of high risk myelodysplastic syndromes

Objective To investigate the clinical value about decitabine combined with CAG in the treatment of high risk myelodysplastic syndromes.Methods The 80 cases of patients admitted to hospital were randomly divided into two groups,control group(n =40) and treatment group(n =40).The control group were only given CAG regimen(Ara-C, Acla,G-CSF),and the treatment group were also given decitabine.The clinical efficacy,the time of survival,the level of vascular endothelial growth factor(VEGF),and the adverse reactions in 2 groups were observed and compared after 6 treatment courses.Results The total overall response rate in the treatment group was significandy higher than pretreatmen and the control group(77.5%vs 55.0%,P<0.05);the overall survival and disease free survival in the treatment group was significantly longer than the control group(32.50±21.64) months vs(24.07±15.23)months and(26.88±17.02) months vs(20. 11±10.45)months respectively,P<0.05);the levels of VEGF in the treatment groupld,3d,7d,14d after treatment were significandy lower than the control group(P<0.05);the main adverse reactions were arrest of bone marrow and lung infection in 2 groups,it was well tolerated.Conclusion The clinical application of decitabine combined with CAG regimen in the treatment of high risk myelodysplastic syndromes are safety and efficacy.