论文部分内容阅读
目的比较高三尖杉酯碱(HHT)、阿糖胞苷(Ara-c)联合粒细胞集落刺激因子(G-CSF)的小剂量预激化疗方案(HAG方案)与阿克拉霉素(aclacinomycin)、Ara-c联合G-CSF的CAG方案治疗高危骨髓增生异常综合征(MDS)的效果及其安全性。方法 52例初诊的高危MDS患者入选HAG方案组,50例初诊的高危MDS患者入选CAG组。1个疗程后初步评价疗效,未缓解者进行第2个疗程,2个疗程后评价治疗效果及不良反应。结果 (1)HAG组2疗程后共25例获完全缓解(CR)(48.1%),11例获部分缓解(PR)(21.2%),总有效率69.2%。CAG组2疗程后23例获CR(46.0%),9例获PR(18.0%),总有效率64.0%。经统计学检验,HAG与CAG方案组比较无统计学差异。(2)HAG组在诱导治疗期间发生粒细胞缺乏的比例为53.8%(28例),平均持续时间4 d,血小板<20×10~9/L的比例为34.6%(18例),平均持续时间5 d;CAG组诱导治疗期间发生粒细胞缺乏的比例为58.0%(29例),平均持续时间6 d,血小板<20×10~9/L的比例为38.0%(19例),平均持续时间7 d。结论 HAG及CAG预激方案治疗高危MDS均能取得较高的缓解率,HAG预激方案骨髓抑制较轻,临床应用较为安全,值得推广应用。
OBJECTIVE: To compare the efficacy of low dose pre-shock chemotherapy (HAG) and aclacinomycin combined with homoharringtonine (HHT), Ara-c and granulocyte-colony stimulating factor (G- , Ara-c combined with G-CSF CAG regimen in the treatment of high-risk myelodysplastic syndrome (MDS) and its safety. Methods 52 newly diagnosed high risk MDS patients were enrolled in the HAG regimen group and 50 newly diagnosed high risk MDS patients were enrolled in the CAG group. After a course of treatment, the initial evaluation of the efficacy of those who did not remission for the second course of treatment, two courses of evaluation of treatment and adverse reactions. Results (1) The complete remission (CR) was achieved in 25 of 25 cases (48.1%) in HAG group and the partial response (PR) in 21 cases (21.2%). The total effective rate was 69.2%. After 2 courses of treatment in CAG group, CR (46.0%) was obtained in 23 cases, PR (18.0%) in 9 cases, and the total effective rate was 64.0%. The statistical test, HAG and CAG no significant difference between the program group. (2) The incidence of agranulocytosis in HAG group was 53.8% (28 cases) during the induction therapy, with an average duration of 4 days and 34.6% (18 cases) of platelets <20 × 10 ~ 9 / L Time was 5 days. The percentage of agranulocytosis during CAG induction therapy was 58.0% (29 cases), the average duration was 6 days, and the proportion of platelets <20 × 10 ~ 9 / L was 38.0% (19 cases) Time 7 d. Conclusions HAG and CAG pre-shock regimen can achieve high remission rate in treating high-risk MDS. HAG pre-shock regimen has less myelosuppression and clinical application is safer and worthy of promotion.