临床荟萃

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CAG及CAG联合地西他滨化疗方案治疗老年急性髓系白血病的疗效比较

  

  1. 天津市第一中心医院 血液科,天津  300192
  • 出版日期:2018-03-05 发布日期:2018-03-19
  • 通讯作者: 通信作者:白雪,Email: baixue0305@126.com
  • 基金资助:
    天津市卫生局科技基金攻关项目(16KG110);天津市自然科学基金资助项目(17JCZDJC35800);天津市卫生局科技基金攻关项目(15KG135)

Curative effect of CAG regimen compared with CAG combined with decitabine regimen in elderly patients with acute myeloid leukemia

  1. Department of Hematology, Tianjin First Central Hospital,   Tianjin   300192,   China
  • Online:2018-03-05 Published:2018-03-19
  • Contact: Corresponding author: Bai Xue, Email: baixue0305@126.com

摘要: 目的  比较CAG及CAG联合地西他滨(DAC)化疗方案治疗老年急性髓系白血病(AML)的疗效。方法 回顾性分析我院诊治的老年AML患者76例,对采用CAG或CAG+DAC两种不同化疗方案做为诱导缓解方案的患者的临床疗效进行分析,分析两组在完全缓解率,总有效率,中位生存期,中位无复发生存期的差异。结果  在老年AML患者,CAG组49例,完全缓解率为51.0%,总有效率为61.2%, CAG+DAC组27例,分别为59.3%和77.8%,两者完全缓解率和总有效率差异无统计学意义(P>0.05);在中位生存期(10.0个月  vs 12.0个月,P=0.225)和无复发生存期(8.0个月  vs  11.0个月,P=0.652)差异无统计学意义。但在高危组患者,CAG+DAC组完全缓解率,总有效率优于CAG组,分别为57.1% vs 15%;71.4% vs 25%,差异有统计学意义(P<0.05)。中位生存期6.0个月  vs 10.0个月及无复发生存期为4.0个月  vs 7.0个月(P>0.05),CAG+DAC组均有延长趋势。 结论  CAG和CAG+DAC化疗方案临床疗效相当,但对预后差的老年AML患者,CAG+DAC在临床疗效方面显示出了优势。

关键词: 白血病, 髓样, 地西他滨, 疗效

Abstract: Objective  To compare the curative effect of CAG regimen and CAG combined with decitabine regimen in elderly patients with acute myeloid leukemia(AML). Methods  Seventysix de novo elderly patients with AML who were diagnosed in our hospital were analyzed by a retrospective analysis. The 76 cases were divided into groups with CAG group and CAG+DAC group according to different chemotherapies.  We compared the differences of complete remission rate, overall response rate, median overall survival and median relapsefree survival in two groups. Results  CAG group of 49 cases:CR rate was 51.0%, ORR was 61.2%; CAG+DAC group of 27 cases: CR rate was 59.3%, ORR was 77.8%. The statistics analysis showed  no significant differences in CR rate and ORR between two groups(P>0.05). There were differences in median OS (10.0 months vs 12.0 months) and median RFS (8.0 months vs 11.0  months ) in  two groups(P>0.05). But in the highrisk group of patients, CR rate and ORR of the CAG+DAC group  were  higher  than  those of CAG group,respectively (57.1% vs 15%; 71.4% vs 25%), the difference was statistically significant(P<0.05). CAG+DAC group was better than CAG group in median OS and median RFS, respectively (6.0 months vs 10.0  months) and (4.0 months vs 7.0 months)(P>0.05). Conclusion  CAG regimen is similar with CAG+DAC regimen in the clinical curative effect, but CAG+DAC regimen is better in the elderly patients with AML with poor prognosis.

Key words: leukemia, myeloid; , decitabine, curative , effect