中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2014年
8期
698-702
,共5页
徐俊卿%徐泽锋%秦铁军%李冰%方力维%张宏丽%胡耐博%潘丽娟%曲士强
徐俊卿%徐澤鋒%秦鐵軍%李冰%方力維%張宏麗%鬍耐博%潘麗娟%麯士彊
서준경%서택봉%진철군%리빙%방력유%장굉려%호내박%반려연%곡사강
骨髓纤维化,原发性%贫血%治疗%沙利度胺%泼尼松%达那唑
骨髓纖維化,原髮性%貧血%治療%沙利度胺%潑尼鬆%達那唑
골수섬유화,원발성%빈혈%치료%사리도알%발니송%체나서
Primary myelofibrosis%Anemia%Treatment%Thalidomide%Prednisone%Danazol
目的 观察小剂量沙利度胺和泼尼松联合或不联合达那唑对原发性骨髓纤维化(PMF)患者贫血的治疗效果.方法 以58例HGB＜100 g/L的PMF患者为研究对象.28例患者接受小剂量沙利度胺和泼尼松治疗(沙利度胺+泼尼松组),30例接受小剂量沙利度胺和泼尼松联合达那唑治疗(沙利度胺+泼尼松+达那唑组).按照2006年骨髓纤维化研究和治疗国际工作组疗效判断标准评价疗效.治疗后3、12个月检测患者骨髓纤维化程度.结果 58例患者总有效率56.9％(33/58),其中部分缓解(PR) 1.7％(1/58),临床改善(CI) 55.2％(32/58).沙利度胺+泼尼松组、沙利度胺+泼尼松+达那唑组总有效率差异无统计学意义(50.0％对63.3％,P=0.306),但后者中位有效持续时间和红系临床改善(CI-E)中位有效持续时间优于前者[75(8～206)周对30(8～86)周,P=0.007;61.5(8～194)周对22(8～86)周,P=0.015].两组患者治疗3个月和12个月时骨髓骨髓纤维化程度较治疗前均有显著改善(P值分别为0.000和0.005).两组不良反应均为1～2级.结论 小剂量沙利度胺和泼尼松为PMF患者贫血的有效治疗方案,联合应用达那唑可显著延长疗效持续时间.
目的 觀察小劑量沙利度胺和潑尼鬆聯閤或不聯閤達那唑對原髮性骨髓纖維化(PMF)患者貧血的治療效果.方法 以58例HGB＜100 g/L的PMF患者為研究對象.28例患者接受小劑量沙利度胺和潑尼鬆治療(沙利度胺+潑尼鬆組),30例接受小劑量沙利度胺和潑尼鬆聯閤達那唑治療(沙利度胺+潑尼鬆+達那唑組).按照2006年骨髓纖維化研究和治療國際工作組療效判斷標準評價療效.治療後3、12箇月檢測患者骨髓纖維化程度.結果 58例患者總有效率56.9％(33/58),其中部分緩解(PR) 1.7％(1/58),臨床改善(CI) 55.2％(32/58).沙利度胺+潑尼鬆組、沙利度胺+潑尼鬆+達那唑組總有效率差異無統計學意義(50.0％對63.3％,P=0.306),但後者中位有效持續時間和紅繫臨床改善(CI-E)中位有效持續時間優于前者[75(8～206)週對30(8～86)週,P=0.007;61.5(8～194)週對22(8～86)週,P=0.015].兩組患者治療3箇月和12箇月時骨髓骨髓纖維化程度較治療前均有顯著改善(P值分彆為0.000和0.005).兩組不良反應均為1～2級.結論 小劑量沙利度胺和潑尼鬆為PMF患者貧血的有效治療方案,聯閤應用達那唑可顯著延長療效持續時間.
목적 관찰소제량사리도알화발니송연합혹불연합체나서대원발성골수섬유화(PMF)환자빈혈적치료효과.방법 이58례HGB＜100 g/L적PMF환자위연구대상.28례환자접수소제량사리도알화발니송치료(사리도알+발니송조),30례접수소제량사리도알화발니송연합체나서치료(사리도알+발니송+체나서조).안조2006년골수섬유화연구화치료국제공작조료효판단표준평개료효.치료후3、12개월검측환자골수섬유화정도.결과 58례환자총유효솔56.9％(33/58),기중부분완해(PR) 1.7％(1/58),림상개선(CI) 55.2％(32/58).사리도알+발니송조、사리도알+발니송+체나서조총유효솔차이무통계학의의(50.0％대63.3％,P=0.306),단후자중위유효지속시간화홍계림상개선(CI-E)중위유효지속시간우우전자[75(8～206)주대30(8～86)주,P=0.007;61.5(8～194)주대22(8～86)주,P=0.015].량조환자치료3개월화12개월시골수골수섬유화정도교치료전균유현저개선(P치분별위0.000화0.005).량조불량반응균위1～2급.결론 소제량사리도알화발니송위PMF환자빈혈적유효치료방안,연합응용체나서가현저연장료효지속시간.
Objective To observe the clinical effects of low-dose thalidomide (THAL) and prednisone (PRED) with or without danazol (DANA) in patients with primary myelofibrosis (PMF) associated anemia.Methods A cohort of 58 PMF patients with anemia (Hb＜100 g/L) were retrospectively studied.Of them,28 patients were treated with THAL and PRED (THAL-PRED group),and the rest with THAL,PRED and DANA (THAL-PRED-DANA group).The hematological response was assessed according to the modified criteria of the Intemational Working Group in 2006,and the myelofibrosis degree was evaluated at 3 and 12 month after treatment.Results The total response rate was 56.9％(33/58) including 1.7％ (1/58) partial remission(PR) and 55.2％ (32/58) clinical improvement (CI).There was no statistical difference in the response rate between THAL-PRED and THAL-PREDDANA groups (50.0％ vs 63.3％,P=0.306).However,the median response duration of clinical improvement,erythroid response (CI-E) and total response prolonged in THAL-PRED-DANA than THALPRED group (61.5w vs 22w,P=0.015; 75w vs 30w,P=0.007,respectively).Myelofibrosis degree at 3 and 12 months after treatment decreased significantly than before treatment (P=0.000 and 0.005,respectively).Side-effects in both groups were only grade 1-2.Conclusions Low-dose THAL together with PRED appeared to be effective in the treatment of PMF-associated anemia,and the response duration would prolong significantly if combined with DANA.
