中国冶金工业医学杂志

地西他滨联合CAG方案治疗难治性急性髓性白血病的疗效研究

作者：宾燕成冯翠吕钊李虎生张华

分类号：R 733.7

出版年,卷(期):页码：2024,41(6):621-623

摘要：

摘要：目的研究地西他滨（DAC）联合CAG方案治疗难治性急性髓性白血病（RAML）的疗效。方法择选2020年6月—2023年6月本院收治的RAML患者80例，按照统计学随机法将其分为对照组和实验组，每组各40例。对照组应用CAG方案治疗，实验组另加用DAC治疗。比较两组的临床疗效、化疗前后免疫细胞指标水平、血小板（PLT）和红细胞输入量、PLT和血红蛋白（HGB）增长幅度、不良反应发生率。结果化疗后，实验组的治疗总有效率及CD3＋、CD4＋、CD4＋／CD8＋水平明显高于对照组，CD8＋水平明显低于对照组；化疗后支持治疗时，实验组的PLT及红细胞输入量明显低于对照组，PLT、HGB增长幅度明显高于对照组。以上指标组间比较均差异显著（χ2＝5.115，t＝5.043、6.632、2.354、5.528、4.798、5.012、21.174、17.528，均P＜0.05）。化疗期间两组不良反应发生率比较无显著差异（χ2＝0.220，P＞0.05）。结论 DAC联合CAG化疗方案能够提高RAML患者的临床疗效，改善免疫状态，抑制肿瘤发展，促进骨髓造血功能恢复，且应用安全。

Abstract：Objective To investigate the efficacy of decitabine （DAC） combined with the CAG regimen in the treatment of refractory acute myeloid leukemia （RAML）. Methods A total of 80 patients with RAML treated in our hospital from June 2020 to June 2023 were selected and randomly divided into a control group and an experimental group, with 40 cases in each group. The control group received the CAG regimen, while the experimental group was additionally treated with DAC. Clinical efficacy, immune cell markers before and after chemotherapy, platelet （PLT） and red blood cell transfusion volumes, increases in PLT and hemoglobin （HGB） levels, and the incidence of adverse reactions were compared between the two groups. Results After chemotherapy, the overall treatment efficacy and levels of CD3＋, CD4＋, and CD4＋/CD8＋ in the experimental group were significantly higher than those in the control group, while the CD8＋ level was significantly lower than that in the control group. During supportive treatment after chemotherapy, the PLT and red blood cell transfusion volumes in the experimental group were significantly lower than those in the control group, and the increases in PLT and HGB levels were significantly higher than those in the control group. These differences between the groups were statistically significant （χ2＝5.115, t＝5.043, 6.632, 2.354, 5.528, 4.798, 5.012, 21.174, 17.528, all P＜0.05）. There was no significant difference in the incidence of adverse reactions between the two groups during chemotherapy （χ2＝0.220, P＞0.05）. Conclusion The DAC combined with the CAG chemotherapy regimen can improve the clinical efficacy in RAML patients, enhance immune function, inhibit tumor progression, promote bone marrow hematopoietic recovery, and is safe to use.

基金项目：

作者简介：

参考文献：

参考文献

［1］ Stubbins RJ，Francis A，Kuchenbauer F，et al. Management of acute myeloid leukemia：a review for general practitioners in oncology［J］. Curr Oncol，2022，29（9）：6245-6259.

［2 ］李仙松，李丹.沙利度胺联合CAG方案对急性髓系白血病患者血管内皮生长因子，碱性成纤维细胞生长因子水平及远期生存率的影响［J］.检验医学与临床，2021，34（2）：94-104.

［3］中华医学会血液学分会白血病淋巴瘤学组.中国复发难治性急性髓系白血病诊疗指南（2021年版）［J］.中华血液学杂志，2021，42（8）：624-627.

［4］钟志娟，卢俊.移植后地西他滨输注治疗儿童难治性急性髓系白血病合并神经母细胞瘤1例［J］.中国小儿血液与肿瘤杂志，2021，26（1）：45-47.

［5］ Niscola P，Mazzone C，Molica M，et al. New landscapes in the management of myelodysplastic syndromes and chronic myelomonocytic leukemia：oral decitabine［J］. Future Oncol，2021，17（16）：1973-1975.

［6］ Dargenio M，Tarantini G，Cascavilla N，et al. Long-term follow-up of elderly patients with acute myeloid leukemia treated with decitabine：a real-world study of the apulian hematological network［J］. Cancers （Basel），2022，14（3）：826.

［7］ Senapati J，Shoukier M，Garcia-Manero G，et al. Activity of decitabine as maintenance therapy in core binding factor acute myeloid leukemia［J］. Am J Hematol，2022，97（5）：574-582.

［8］胡芮，高媛，闻艳，等.地西他滨对骨髓增生异常综合征/急性髓系白血病患者外周血及骨髓中调节性T细胞相对含量的影响研究［J］.中国实验血液学杂志，2022，30（1）：36-42.

［9］苑晓磊，胡东博，张国福，等.地西他滨治疗成人急性髓系白血病临床效果及对肿瘤相关巨噬细胞、免疫功能的影响［J］.解放军医药杂志，2022，34（2）：28-31.

服务与反馈：

【文章下载】【加入收藏】