论文部分内容阅读
目的:探讨国产地西他滨单药治疗老年骨髓增生异常综合征(MDS)的临床疗效和安全性。方法:评价我院2013-07-2015-06使用国产地西他滨(25 mg×5 d)治疗15例中危或不能耐受联合化疗的高危老年初治MDS患者的疗效和不良反应。结果:15例MDS患者中位年龄70岁,中危Ⅰ9例,中危Ⅱ及高危6例。至少经过3个疗程的治疗,6例获得完全缓解,2例获得部分缓解,2例脱离成分血输注,1例疾病稳定,4例未缓解,总反应率达66.7%。在6例细胞遗传学异常的患者中,5例获得完全细胞遗传学缓解,1例获得部分细胞遗传学缓解。Ⅲ~Ⅳ级血液学毒性发生率为73.3%,Ⅲ~Ⅳ级感染发生率为53.3%,无一例发生Ⅲ~Ⅳ级出血、严重恶心呕吐和肝功能损害。中位随访时间12(2~24)个月,随访期间1例死亡。结论:国产地西他滨治疗中危或不能耐受联合化疗的高危MDS可取得良好的疗效。
Objective: To investigate the clinical efficacy and safety of domestic decitabine monotherapy in the treatment of senile myelodysplastic syndrome (MDS). Methods: To evaluate the efficacy and adverse reactions of domestic decitabine (25 mg × 5 d) in the treatment of 15 newly diagnosed MDS patients at high risk of middle-age or intolerance in combination with chemotherapy. Results: Fifteen patients with MDS were 70 years old, moderate-risk Ⅰ9 cases, intermediate-risk Ⅱ cases and high-risk cases 6 cases. After at least 3 courses of treatment, 6 cases achieved complete remission, 2 cases achieved partial remission, 2 cases were separated from blood transfusions, 1 case was stable, 4 cases did not relieve, and the total response rate was 66.7%. Of the 6 patients with cytogenetic abnormalities, 5 had complete cytogenetic response and 1 received cytogenetic response. The grade Ⅲ ~ Ⅳ hematological toxicity was 73.3%, and the grade Ⅲ ~ Ⅳ infection was 53.3%. No case of grade Ⅲ ~ Ⅳ hemorrhage, severe nausea and vomiting and liver dysfunction occurred. The median follow-up time was 12 (2-24) months and 1 died during follow-up. CONCLUSION: Domestic decitabine can be used to treat high-risk MDS in middle-risk or inoperable combination chemotherapy.