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目的探讨地西他滨(DAC)联合抗CD33单抗(GO)治疗难治性急性髓细胞性白血病(AML)的疗效和安全性。方法对2例难治性AML(M4)患者均进行1个疗程的DAC联合GO治疗(具体剂量为DAC:20 mg.m-2.d-1×5 d,第1～5天,GO 9 mg/m2,第6天),应用骨髓涂片、定期监测血常规评价其疗效。结果经过1个疗程的DAC联合GO治疗后,1例患者未出现疾病进展,骨髓中原幼细胞由35%降至27.5%,巨核细胞由2个/片增加至(200个/片,血小板由减少改善为数量基本正常,临床上血小板恢复正常水平,一般情况良好。另1例在治疗期间高白细胞得以控制,治疗后第15天复查骨髓提示原幼细胞由38.5%降至12.5%,获得部分缓解。2例患者均未出现肝静脉闭塞病(VOD)及其他脏器功能损害表现。结论 DAC联合GO治疗难治性AML安全可行,尤其是对于一般情况差、不能耐受高剂量化疗或高剂量挽救化疗失败的患者,不失为一种新的治疗选择。
Objective To investigate the efficacy and safety of decitabine (DAC) combined with anti-CD33 monoclonal antibody (GO) in the treatment of refractory acute myelogenous leukemia (AML). Methods Two patients with refractory AML (M4) received one course of DAC combined with GO (specific dose: DAC: 20 mg.m-2.d-1 × 5 d, days 1 to 5, GO 9 mg / m2, day 6), the application of bone marrow smear, regular monitoring of blood routine evaluation of its efficacy. Results After one course of DAC combined with GO treatment, one patient had no disease progression, the number of meiotic neutrophils decreased from 35% to 27.5%, and the number of megakaryocytes increased from 2 to 200 Improved to the number of normal, clinically normal level of platelet recovery, the general situation is good.Another case of high white blood cells during treatment to be controlled after 15 days of treatment review of bone marrow prompted the original cells from 38.5% to 12.5%, to obtain partial response .2 patients showed no symptoms of hepatic veno-occlusive disease (VOD) and other organ dysfunction.Conclusion DAC combined with GO in the treatment of refractory AML is safe and feasible, especially for patients with poor general conditions, which can not tolerate high-dose chemotherapy or high dose Saving the failure of chemotherapy patients, after all, a new treatment option.