论文部分内容阅读
目的探讨低剂量地西他滨治疗中高危骨髓增生异常综合征(myelodysplastic syndrome,MDS)患者的疗效及安全性。方法 38例中高危MDS患者,均在常规治疗基础上给予低剂量地西他滨25mg/d微量泵泵注,1h泵注完毕,第1~4或1~5或1~6天,每28d为1个周期。每周期治疗后评价疗效,记录不良反应发生情况,并随访观察患者生存情况。结果 38例共完成115个周期治疗,其中完成1个周期者9例,完成2个周期者12例,完成3个周期者5例,完成4个周期者5例,完成6个周期者3例,完成7个周期者3例,完成8个周期者1例;总有效率为73.68%,其中完全缓解10例,骨髓完全缓解6例,血液学改善12例;115个周期中,Ⅲ~Ⅳ度贫血发生率为37.39%(43/115),Ⅲ~Ⅳ度中性粒细胞减少发生率为40.87%(47/115),Ⅲ~Ⅳ度血小板减少发生率为40.00%(46/115),Ⅲ~Ⅳ度感染发生率为13.91%(16/115),Ⅲ~Ⅳ度出血发生率为1.74%(2/115);骨髓抑制期内死亡3例(7.9%),无因药物不良反应停药病例,治疗30d内无死亡患者;随访至2015年11月30日,3例失访,4例死亡,31例存活,中位生存期为14.3个月,1a累积生存率为52.1%。结论低剂量地西他滨治疗中高危MDS疗效满意,严重不良反应发生率低。
Objective To investigate the efficacy and safety of low-dose decitabine in the treatment of middle-high myelodysplastic syndrome (MDS). Methods Thirty-eight patients with high-risk MDS were given a low-dose injection of decitabine 25mg / d on the basis of routine treatment. After 1h of injection, the patients were injected 1 to 4 or 1 to 5 or 1 to 6 days, For 1 cycle. After each treatment period, the curative effect was evaluated, the incidence of adverse reactions was recorded, and the survival of the patients was followed up. Results 38 cases completed a total of 115 cycles of treatment, including the completion of a cycle in 9 cases, completed two cycles in 12 cases, completed 3 cycles in 5 cases, completed 4 cycles in 5 cases, complete 6 cycles in 3 cases , 3 cases completed 7 cycles and 1 case completed 8 cycles. The total effective rate was 73.68%, of which 10 cases were completely relieved, 6 cases had bone marrow complete remission, 12 cases improved hematology. Among 115 cycles, Ⅲ ~ Ⅳ The incidence of degree anemia was 37.39% (43/115), the incidence of grade Ⅲ ~ Ⅳ neutropenia was 40.87% (47/115), and the incidence of grade Ⅲ ~ Ⅳ thrombocytopenia was 40.00% (46/115) The incidence of grade Ⅲ-Ⅳ infection was 13.91% (16/115), the incidence of grade Ⅲ-Ⅳ hemorrhage was 1.74% (2/115), and 3 cases died of bone marrow suppression (7.9%). No adverse drug reactions occurred No patients died within 30 days of treatment. Three patients were lost to follow-up on Nov. 30, 2015, 4 died and 31 survived. The median survival time was 14.3 months and the cumulative survival rate was 1a (52.1%). Conclusion Low-dose decitabine can treat middle-high risk MDS patients with satisfactory results and low incidence of serious adverse reactions.