[1]晏建国,胡 飞,郭 瑛,等.中剂量阿糖胞苷巩固强化治疗老年AML患者疗效和安全性[J].医学信息,2019,32(24):63-65.[doi:10.3969/j.issn.1006-1959.2019.24.020]
 YAN Jian-guo,HU Fei,GUO Ying,et al.Efficacy and Safety of Medium-dose Cytarabine Intensive Treatment in Elderly Patients with AML[J].Medical Information,2019,32(24):63-65.[doi:10.3969/j.issn.1006-1959.2019.24.020]
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中剂量阿糖胞苷巩固强化治疗老年AML患者疗效和安全性()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年24期
页码:
63-65
栏目:
论著
出版日期:
2019-12-15

文章信息/Info

Title:
Efficacy and Safety of Medium-dose Cytarabine Intensive Treatment in Elderly Patients with AML
文章编号:
1006-1959(2019)24-0063-03
作者:
晏建国胡 飞郭 瑛朱文凤李金凤欧阳贤凤罗 萍
(九江市第一人民医院血液内科,江西 九江 332000)
Author(s):
YAN Jian-guoHU FeiGUO YingZHU Wen-fengLI Jin-fengOUYANG Xian-fengLUO Ping
(Department of Hematology,Jiujiang First People’s Hospital,Jiujiang 332000,Jiangxi,China)
关键词:
阿糖胞苷白血病髓样急性老年人巩固强化
Keywords:
CytarabineLeukemiaMyeloidAcuteElderlyConsolidation
分类号:
R733.71
DOI:
10.3969/j.issn.1006-1959.2019.24.020
文献标志码:
A
摘要:
目的 观察中剂量阿糖胞苷巩固强化治疗在初治老年急性髓系白血病(AML)患者的临床疗效和不良反应。方法 回顾性分析2012年10月~2017年2月在我院诊治的2个疗程内达完全缓解(CR)的初治老年AML(非APL)患者58例,将应用中剂量阿糖胞苷进行巩固强化治疗的33例设为中剂量阿糖胞苷组,应用标准剂量阿糖胞苷进行巩固强化治疗的25例设为标准剂量阿糖胞苷组,比较两组总生存(OS)时间、无复发生存(RFS)时间、3年生存率、累积复发率及不良反应发生情况。结果 中剂量阿糖胞苷组OS时间长于标准剂量阿糖胞苷组 [(47.15±17.46)个月 vs(21.76±11.24)个月](P=0.000);中剂量阿糖胞苷组RFS时间长于标准剂量阿糖胞苷组 [(44.82±17.15)个月vs(18.88±10.28)个月](P=0.000);中剂量阿糖胞苷组和标准剂量阿糖胞苷组3年生存率分别为30.30%(10/33)和 16.00%(4/25),两组比较,差异无统计学意义(P=0.207);两组累积复发率分别为24.24%(8/33)和56.00%(14/25)(P=0.014)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 应用中剂量阿糖胞苷巩固强化治疗初治CR老年AML患者,有助于延长患者的OS、RFS时间,降低患者的累计复发率,不良反应发生率低。
Abstract:
Objective To observe the clinical efficacy and adverse reactions of medium-dose cytarabine consolidation and intensive therapy in newly treated elderly patients with acute myeloid leukemia (AML). Methods A retrospective analysis of 58 newly treated elderly AML (non-APL) patients who achieved complete remission (CR) within two courses of treatment in our hospital from October 2012 to February 2017, will be consolidated with medium-dose cytarabine 33 cases of intensive treatment were set in the medium-dose cytarabine group, and 25 cases of standard-dose cytarabine for consolidation and intensive treatment were set in the standard-dose cytarabine group.The total survival (OS) time, recurrence-free survival (RFS) time, 3-year survival rate, cumulative recurrence rate, and adverse events were compared between the two groups. Results The OS time in the medium-dose cytarabine group was longer than that in the standard-dose cytarabine group [(47.15 ± 17.46) months vs (21.76 ± 11.24) months](P = 0.000); The RFS time in the cytidine group was longer than that in the standard-dose cytarabine group [(44.82 ± 17.15) months vs (18.88 ± 10.28) months](P = 0.000); the medium-dose cytarabine group and The 3-year survival rates of the standard-dose cytarabine group were 30.30% (10/33) and 16.00% (4/25). There was no significant difference between the two groups (P = 0.207);The cumulative recurrence rates in the two groups were 24.24% (8/33) and 56.00% (14/25)(P = 0.014). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05).Conclusion The application of medium-dose cytarabine to strengthen and strengthen the treatment of elderly CR patients with AML can help prolong the OS and RFS time of patients, reduce the cumulative recurrence rate of patients, and reduce the incidence of adverse reactions.

参考文献/References:

[1]Hilberink J,Hazenberg C,van den Berg E,et al.Not type of induction therapy but consolidation with allogeneic hematopoietic cell transplantation determines outcome in older AML patients: A single center experience of 355 consecutive patients[J].Leuk Res,2019(80):33-39.[2]Dinmohamed AG,Visser O,van Norden Y,et al.Treatment,trial participation and survival in adult acute myeloid leukemia: a population-based study in the Netherlands,1989-2012[J].Leukemia,2016,30(1):24-31.[3]Veltri L,Rezvani K,Oran B,et al.Allotransplants for Patients 65 Years or Older with High-Risk Acute Myeloid Leukemia[J].Biol Blood Marrow Transplant,2019,25(3):505-514.[4]周宏伟,周敏航,王志红,等.地西他滨单药或联合以阿糖胞苷为基础的低剂量化疗方案治疗老年急性髓系白血病的临床分析[J].中国实验血液学杂志,2018,26(1):91-96.[5]Dohner H,Estey EH,Amadori S,et al.Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet[J].Blood,2010,115(3):453-474.[6]Dohner H,Weisdorf DJ,Bloomfield CD.Acute Myeloid Leukemia[J].N Engl J Med,2015,373(12):1136-1152.[7]Klepin HD.Myelodysplastic Syndromes and Acute Myeloid Leukemia in the Elderly[J].Clin Geriatr Med,2016,32(1):155-173.[8]Willemze R,Suciu S,Meloni G,et al.High-dose cytarabine in induction treatment improves the outcome of adult patients younger than age 46 years with acute myeloid leukemia:results of the EORTC-GIMEMA AML-12 trial[J].J Clin Oncol,2014,32(3):219-228.[9]张之南,沈悌.血液病诊断及疗效标准[M].第3版.北京:科出版社,2007.[10]Li WY,Wang Y,Chen SN,et al.Consolidation therapy with decitabine and intermediate-dose cytarabine followed by HLA-mismatched peripheral blood stem cells infusion for older patients with acute myeloid leukemia in first remission[J].Leuk Lymphoma,2018,59(7):1652-1658.[11]Mayer RJ,Davis RB,Schiffer CA,et al.Intensive postremission chemotherapy in adults with acute myeloid leukemia. Cancer and Leukemia Group B[J].N Engl J Med,1994,331(14):896-903.[12]陈梦欢,甘思林,孙慧等.中剂量阿糖胞苷用于老年急性髓系白血病患者巩固强化治疗的临床观察[J].白血病·淋巴瘤,2017,26(5):276-279.[13]闫金松.高剂量阿糖胞苷治疗急性髓细胞白血病的决策与争议[J].医学与哲学,2018,39(16):7-11,24.

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更新日期/Last Update: 2019-12-15