| 黄赛兰,赵晓东,王 瑶,郑雨雨,林国强,张兴霞,赵广圣,司叶俊,张彦明.阿扎胞苷单药或联合HAG方案在骨髓增生异常综合征中的临床观察[J].,2022,(5):935-939 |
| 阿扎胞苷单药或联合HAG方案在骨髓增生异常综合征中的临床观察 |
| Clinical Observation of Azacitidine or Combined with HAG Regimen in Myelodysplastic Syndrome |
| 投稿时间：2021-05-27 修订日期：2021-06-23 |
| DOI：10.13241/j.cnki.pmb.2022.05.028 |
| 中文关键词: 阿扎胞苷 预激方案 骨髓增生异常综合征 临床观察 疗效评价 |
| 英文关键词: Azacitidine Priming regimen Myelodysplastic syndromes Clinical observation Efficacy evaluation |
| 基金项目:江苏省卫计委面上项目（M2020058）；江苏省"333工程"项目（BRA2017246）；淮安市自然科学研究计划（HAB201814）；江苏省重点实验室开放课题（XZSYSKF2020038） |
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| 中文摘要: |
| 摘要 目的：探究阿扎胞苷（Azacitidine，AZA）单药或联合HAG方案治疗骨髓增生异常综合征（Myelodysplastic syndromes，MDS）的临床疗效及安全性。方法：回顾性分析49例MDS患者的临床资料，根据治疗方法不同分为支持治疗组和含AZA组（单药或联合HAG方案），统计分析患者的临床疗效及不良反应情况。结果：支持治疗组的总有效率（Overall response rate，ORR）为30.00 %（6/20），包括0例完全缓解（Complete remission，CR），1例骨髓完全缓解（Marrow complete remission，mCR），2例部分缓解（Partial remission，PR）, 3例血液学改善（Hematological improvement，HI）。含AZA组的ORR为65.52 %，包括8例CR、2例mCR、4例PR、5例HI。其中单药组的ORR为46.67 %, 包括2例CR、1例mCR、2例PR、2例HI；联合组的ORR为85.71 %，包括6例CR、1例mCR、2例PR、3例HI。与支持治疗组相比，含AZA组的完全缓解率（CR+mCR）及ORR显著增高，差异有统计学意义（P＜0.05）。患者最常见的不良反应是III-IV级骨髓抑制（18/29）及继发感染（10/29），且随着疗程数的增加不良事件逐渐减少。含AZA组患者的中位总生存（Overall survival，OS）时间及中位无进展生存时间（Progression-free survival，PFS）时间显著延长（P＜0.05）。结论：该小系列研究的初步结果表明，与支持治疗相比，AZA单药或联合HAG方案治疗MDS有更高的治疗反应，可延长患者总生存期，患者有良好的耐受性，且联合治疗方案可能有更好的疗效。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical efficacy and safety of azacitidine(AZA) or combined with HAG regimen in the treatment of myelodysplastic syndrome (MDS). Methods: The clinical data of 49 patients with MDS in our hospital were retrospectively analyzed. According to different treatment methods, they were divided into supportive treatment group and AZA containing group (AZA or combined with HAG regimen). The clinical efficacy and adverse reactions of the patients were statistically analyzed. Results: In the supportive treatment group, the overall response rate (ORR) was 30.00%, including 0 case complete remission (CR), 1 case of bone marrow complete remission (mCR), 2 cases of partial remission (PR), 3 cases of hematological improvement (HI). The ORR of the AZA containing group was 65.52%, including 8 cases CR, 2 case mCR, 4 cases PR and 5 cases HI. The ORR of monotherapy group was 46.67%, including 2 cases CR, 1 case mCR, 2 cases PR, 2 cases HI. The ORR of combination group was 85.71%, including 6 cases CR, 1 case mCR, 2 cases PR, 3 cases HI. Compared with the supportive treatment group, the complete remission rate and ORR in the group containing AZA were significantly higher than those in the treatment group, and the difference was statistically significant(P<0.05). After receiving AZA containing regimen, the most common adverse reactions were grade III-IV myelosuppression(18/29) and secondary infection(10/29), and the incidence gradually decreased with the increase of treatment courses. Compared with the supportive treatment group, the median Overall survival time and median Progression-free survival time of patients with AZA were significantly longer(P＜0.05). Conclusion: The results of this small sample retrospective case study show that compared with supportive treatment, AZA or combined with HAG regimen has a higher response rate in the treatment of MDS patients, can prolong the overall survival time of patients, and is well tolerated. And combination therapy may have a better effect. |
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