中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
9期
38-39
,共2页
徐玉秀%张勇刚%王萍%高红秀%钟亚平%王萌%李慧%刘迎庆
徐玉秀%張勇剛%王萍%高紅秀%鐘亞平%王萌%李慧%劉迎慶
서옥수%장용강%왕평%고홍수%종아평%왕맹%리혜%류영경
去甲基化药物%中高危骨髓增生异常综合征%老年急性髓系白血病%疗效
去甲基化藥物%中高危骨髓增生異常綜閤徵%老年急性髓繫白血病%療效
거갑기화약물%중고위골수증생이상종합정%노년급성수계백혈병%료효
Demethylating drugs%High-risk myelodysplastic syndrome%Elderly patients with acute myeloid leukemia%Effect
目的 探讨老年急性髓系白血病(AML)和中高危骨髓增生异常综合征(MDS)采用去甲基化药物治疗的临床效果.方法 选择驻马店市中心医院2012年1月至2014年3月收治的中高危骨髓增生异常综合征和老年急性髓系白血病患者共16例,均采用去甲基化药物地西他滨治疗,回顾其临床资料.结果 16例中完全缓解3例,部分缓解1例,病情稳定7例,病情进展1例,死亡4例.疾病控制11例,控制率为68.8％,生存期为(11.6±2.2)个月.观察不良反应,5d剂量组Ⅲ～Ⅳ度骨髓抑制伴发热、肺部感染率低于3d剂量组(P＜0.05).并发出血3例,乏力5例,轻度呕吐、恶心2例,轻度腹泻2例.结论 针对中高危MDS和老年急性髓系白血病患者,除应用最理想的对症支持治疗外,地西他滨可作为一个新的治疗手段,效果更佳,支持治疗更为显著,可使死亡时间及MDS发展为AML的时间延缓,增加疗程数.观察血液学不良反应,以感染和Ⅲ～Ⅳ度骨髓抑制最多见.治疗过程中需加强输血及抗感染治疗,以从整体上改善预后,保障患者的生存质量.
目的 探討老年急性髓繫白血病(AML)和中高危骨髓增生異常綜閤徵(MDS)採用去甲基化藥物治療的臨床效果.方法 選擇駐馬店市中心醫院2012年1月至2014年3月收治的中高危骨髓增生異常綜閤徵和老年急性髓繫白血病患者共16例,均採用去甲基化藥物地西他濱治療,迴顧其臨床資料.結果 16例中完全緩解3例,部分緩解1例,病情穩定7例,病情進展1例,死亡4例.疾病控製11例,控製率為68.8％,生存期為(11.6±2.2)箇月.觀察不良反應,5d劑量組Ⅲ～Ⅳ度骨髓抑製伴髮熱、肺部感染率低于3d劑量組(P＜0.05).併髮齣血3例,乏力5例,輕度嘔吐、噁心2例,輕度腹瀉2例.結論 針對中高危MDS和老年急性髓繫白血病患者,除應用最理想的對癥支持治療外,地西他濱可作為一箇新的治療手段,效果更佳,支持治療更為顯著,可使死亡時間及MDS髮展為AML的時間延緩,增加療程數.觀察血液學不良反應,以感染和Ⅲ～Ⅳ度骨髓抑製最多見.治療過程中需加彊輸血及抗感染治療,以從整體上改善預後,保障患者的生存質量.
목적 탐토노년급성수계백혈병(AML)화중고위골수증생이상종합정(MDS)채용거갑기화약물치료적림상효과.방법 선택주마점시중심의원2012년1월지2014년3월수치적중고위골수증생이상종합정화노년급성수계백혈병환자공16례,균채용거갑기화약물지서타빈치료,회고기림상자료.결과 16례중완전완해3례,부분완해1례,병정은정7례,병정진전1례,사망4례.질병공제11례,공제솔위68.8％,생존기위(11.6±2.2)개월.관찰불량반응,5d제량조Ⅲ～Ⅳ도골수억제반발열、폐부감염솔저우3d제량조(P＜0.05).병발출혈3례,핍력5례,경도구토、악심2례,경도복사2례.결론 침대중고위MDS화노년급성수계백혈병환자,제응용최이상적대증지지치료외,지서타빈가작위일개신적치료수단,효과경가,지지치료경위현저,가사사망시간급MDS발전위AML적시간연완,증가료정수.관찰혈액학불량반응,이감염화Ⅲ～Ⅳ도골수억제최다견.치료과정중수가강수혈급항감염치료,이종정체상개선예후,보장환자적생존질량.
Objective To investigate the clinical effect of demethylating drug therapy on acute myeloid leukocytes and myelodysplastic syndrome.Methods Sixteen cases of elderly patients with highrisk myelodysplastic syndrome and acute myeloid in Central Hospital of Zhumadian from April 2012 to April 2014 were selected and conducted demethylating drugs treatment.The clinical data was reviewed.Results The 16 cases included 3 cases of CR,1 cases of PR,7 cases of SD,1 cases of PD,and 4 deaths.Eleven cases had disease control,and the control rate was 68.8％,and the average survival time was(11.6 ± 2.2) months.Adverse reactions observed,the rate of Ⅲ-Ⅳ degree of bone marrow suppression with fever and lung infection in 5d-dose group was lower than that of 3d-dose group(P ＜ 0.05).There were also complications,3 cases of bleeding,5 cases of fatigue,2 cases of mild vomiting and nausea,2 cases of mild diarrhea.Conclusions For high-risk MDS and acute myeloid leukemia in elderly patients,besides the application of the best programs symptomatic and supportive treatment,decitabine pharmacological properties can be selected as another new treatment,which is more effective.It prolong the time of death and delay the progression to AML,increasing number of courses.Observed hematologic adverse reactions to infection and Ⅲ-Ⅳ myelosuppression is most prevalent.The process of blood transfusion therapy and anti-infection treatment need to be strengthened to improve the prognosis of the whole and to protect the quality of life of patients.
