本文選題：地西他濱 + 骨髓增生異常綜合征　； 參考：《中國實驗血液學雜志》2017年05期

【摘要】：目的:觀察地西他濱聯合小劑量去甲氧柔紅霉素、阿糖胞苷(DAC+IA)方案治療骨髓增生異常綜合征伴原始細胞增多的臨床療效。方法:回顧性分析2015年6月-2017年1月在西安交通大學第一附屬醫(yī)院血液科治療的37例骨髓增生異常綜合征伴原始細胞增多患者,分別采用DAC+IA方案(19例)和單用DAC(18例)方案治療,觀察其臨床療效和不良反應。結果:1-2療程后,DAC+IA組CR+CRi率為57.9%,總反應率100%,骨髓病理組織幼稚細胞明顯減少,外周血中性粒細胞、血紅蛋白、血小板水平顯著提高,完全緩解中位持續(xù)時間7.3月,無進展生存時間為10月,3例患者緩解后停止治療,3.5月復發(fā)。DAC組CR+CRi率為16.7%,總反應率38.9%,中位無進展生存時間為6月。3例患者達到完全緩解,中位時間4個月均進展為AML。兩組患者常見的不良反應為骨髓抑制和感染,其差異無統(tǒng)計學意義。結論:DAC聯合小劑量IA方案治療骨髓增生異常綜合征伴原始細胞增多,可延長患者生存期,改善生存質量,近期療效顯著,但遠期療效仍有待于異基因造血干細胞移植進行鞏固。
[Abstract]:Aim: to observe the clinical effect of combination of dicitabine and low dose normodaunorubicin, cytosine arabinoside DAC IAA regimen in the treatment of myelodysplastic syndrome (MDS) with proliferation of primitive cells. Methods: a retrospective analysis of 37 patients with myelodysplastic syndrome (MDS) associated with primitive cell proliferation was performed in the Department of Hematology, first affiliated Hospital of Xi'an Jiaotong University from June 2015 to January 2017. DAC IA regimen (n = 19) and DAC(18 regimen (n = 19) were used to observe the clinical efficacy and adverse reactions. Results the CR CRi rate was 57.9, the total response rate was 100%, the neutrophils, hemoglobin and platelet levels in the bone marrow tissue decreased significantly, and the median remission duration was 7.3 months after one or two courses of treatment. No progression survival time was achieved in 3 patients after remission in October, CR CRi rate was 16.7in 3.5 months recurrence group, total response rate was 38.9, median progression-free survival time was 6 months, complete remission was achieved in 3 patients, and the median time was 4 months. The common adverse reactions of the two groups were bone marrow suppression and infection, the difference was not statistically significant. Conclusion the treatment of myelodysplastic syndromes combined with small dose IA regimen can prolong the survival time and improve the quality of life in patients with myelodysplastic syndromes. The short-term curative effect is remarkable, but the long-term effect still needs to be consolidated by allogeneic hematopoietic stem cell transplantation.
【作者單位】： 西安交通大學第一附屬醫(yī)院血液內科;
【分類號】：R551.3

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