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目的:探讨不同剂量地西他滨治疗骨髓增生异常综合征(MDS)的临床疗效。方法:地西他滨治疗中高危MDS患者29例,根据患者应用地西他滨剂量的不同,分为8 d方案组(12 mg·m~(-2)·d~(-1)×8 d,11例)和5d方案组(20 mg·m~(-2)·d~(-1)×5 d,18例),比较2组地西他滨的疗效及不良反应。结果:29例患者中完全缓解(CR)率为37.9%,总有效率(ORR)为62.1%。8 d方案组及5 d方案组CR率分别为45.5%和33.3%,ORR分别为72.7%和55.6%,2组比较均差异无统计学意义。地西他滨应用后,2组各疗程发生各级粒细胞及Ⅲ~Ⅳ级血红蛋白减少均差异无统计学意义,但8 d方案组各疗程发生各级血红蛋白及血小板减少均较5 d方案组轻(P<0.05),2组骨髓抑制期三系血细胞最低值差异无统计学意义。感染仍为骨髓抑制期主要并发症,其中40.0%的用药疗程中出现感染,肺部细菌感染占首位。结论:8 d方案和5 d方案均有较好的疗效,但8 d方案骨髓抑制程度轻,安全性更高。
Objective: To investigate the clinical efficacy of different doses of decitabine in the treatment of myelodysplastic syndrome (MDS). Methods: Decitabine was given to 29 middle- and high-risk MDS patients. According to the dose of decitabine in patients, they were divided into 8 days and 12 mg · m -2 d · (-1) × 8 d, 11 cases) and 5d group (20 mg · m -2 · d -1 × 5 days, 18 cases). The efficacy and side effects of decitabine in both groups were compared. Results: The complete remission (CR) rate was 37.9% in 29 patients and the total effective rate (ORR) was 62.1%. The CR rates of the 8 d group and the 5 d group were 45.5% and 33.3%, respectively, and the ORR were 72.7% and 55.6% respectively. There was no significant difference between the two groups. Decitabine application, the two groups of each course of treatment of granulocytes at all levels and grade Ⅲ ~ Ⅳ hemoglobin reduction was no significant difference, but the 8 d regimen of each course of hemoglobin and thrombocytopenia at all levels than the 5 d program group Light (P <0.05). There was no significant difference in the lowest value of the three lines of blood cells in the two groups during myelosuppression. Infection is still the main complication of myelosuppression, of which 40.0% of the medication during the course of infection, lung bacterial infection in the first place. CONCLUSION: Both 8-day and 5-day programs have a good curative effect, but the 8-day regimen has less bone marrow suppression and higher safety.