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目的:探讨地西他滨联合CAG(DCAG)治疗高龄初诊急性髓系白血病(acute myeloid leukemia,AML)患者的疗效和安全性。方法:25例≥80岁初诊AML患者接受DCAG方案:地西他滨15 mg/(m2·d),第1~5天;阿克拉霉素10 mg/d,第3~6天;Ara-C 10 mg/m2,皮下注射,每12 h 1次,第3~9天;G-CSF 300μg/d,皮下注射,第0~9天。观察患者疗效和耐受性。结果:1个疗程后完全缓解(CR)率为71%,部分缓解(PR)率为9.5%。染色体核型分组,预后中等组CR率为81.8%;预后差组CR率为62.5%。患者中位总生存率(OS)10个月(1~61个月),CR者的中位无病生存(DFS)达14个月,血液学毒性为最主要的不良反应,中性粒细胞恢复至0.5×109个/L的中位时间为14 d,血小板恢复至20×109个/L的中位时间为12 d,3例(12.5%)早期死亡。但13例患者缺乏后续规范性治疗。结论:DCAG治疗≥80岁初诊AML患者,疗效好,不良反应可耐受。
Objective: To investigate the efficacy and safety of decitabine combined with CAG (DCAG) in the treatment of elderly patients with acute myeloid leukemia (AML). Methods: 25 cases of newly diagnosed AML patients aged ≥80 years underwent DCAG regimen: decitabine 15 mg / (m2 · d) for days 1 to 5, aclacinomycin 10 mg / d for days 3 to 6, Ara- C 10 mg / m2, subcutaneously, every 12 h, 3 to 9 days; G-CSF 300μg / d, subcutaneous injection, 0 to 9 days. Observe the efficacy and tolerability of the patients. Results: After 1 course of treatment, the complete remission (CR) rate was 71% and the partial remission (PR) rate was 9.5%. Chromosome karyotype group, the prognosis of moderate CR rate of 81.8%; poor prognosis group CR rate of 62.5%. The median overall survival (OS) was 10 months (range 1 to 61 months), median disease-free survival (DFS) was 14 months in CR, and hematologic toxicity was the major adverse effect. Neutrophils The median time to recovery to 0.5 × 109 cells / L was 14 days. The median time to platelet recovery to 20 × 109 cells / L was 12 days. Three patients (12.5%) died early. However, 13 patients lack of follow-up normative treatment. Conclusion: DCAG can treat AML patients newly diagnosed ≥80 years old with good curative effect and tolerable adverse reactions.