地西他滨单药与CAG／HAG方案治疗难治性贫血伴有原始细胞增多的疗效和安全性比较
【摘要】目的比较地西他滨（DAC）单药与以小剂量阿糖胞苷（Ara．C）为基础的CAG／HAG（阿克拉霉素／高二三尖杉酯碱＋Ara-C＋G—CSF）方案治疗骨髓增生异常综合征（MDS）难治性贫血伴有原始细胞增多（RAEB）的疗效及安全性。方法回顾性分析2008年12月至2016年10月中国医学科学院血液病医院MDS诊疗中心121例MDS—RAEB患者临床资料，其中59例接受DAC20mg·m^-2·d^-1×5d方案治疗，62例接受CAG／HAG方案治疗，比较两组患者的总反应率（0RR）、总生存（OS）率及不良反应发生率。结果DAC组、CAG／HAG组患者的ORR分别为66．2％和56．4％，差...
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| Published in | 中华血液学杂志 Vol. 38; no. 7; pp. 572 - 577 |
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| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
300020 天津,中国医学科学院、北京协和医学院血液学研究所、血液病医院,实验血液学国家重点实验室
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0253-2727 |
| DOI | 10.3760/cma.j.issn.0253-2727.2017.07.004 |
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| Abstract | 【摘要】目的比较地西他滨（DAC）单药与以小剂量阿糖胞苷（Ara．C）为基础的CAG／HAG（阿克拉霉素／高二三尖杉酯碱＋Ara-C＋G—CSF）方案治疗骨髓增生异常综合征（MDS）难治性贫血伴有原始细胞增多（RAEB）的疗效及安全性。方法回顾性分析2008年12月至2016年10月中国医学科学院血液病医院MDS诊疗中心121例MDS—RAEB患者临床资料，其中59例接受DAC20mg·m^-2·d^-1×5d方案治疗，62例接受CAG／HAG方案治疗，比较两组患者的总反应率（0RR）、总生存（OS）率及不良反应发生率。结果DAC组、CAG／HAG组患者的ORR分别为66．2％和56．4％，差异无统计学意义（x^2=1．185，P=0．276）。CAG／HAG组1个疗程起效率明显高于DAC组（94．3％对69．2％），两组患者起效疗程数总体比较差异有统计学意义（x^2=7．612，P=0．009）。DAC组中位OS时间为19．5（95％CI10．5～28．4）个月，CAG／HAG组中位0s时间为20．3（95％CI10．7～29．9）个月，两组差异无统计学意义（x^2=0．004，Jp=0．947）。两组患者的不良反应主要是3~4级血细胞减少和相关感染，CAG／HAG组血细胞减少发生率明显高于DAC组（100．0％对64．4％，P〈0．001），CAG／HAG组第3个疗程相关感染发生率明显高于DAC组（52．9％对15．2％，P=0．008）。结论DAC单药和CAG／HAG治疗MDS．RAEB的疗效相当，CAG／HAG方案起效更快，DAC单药治疗安全性更好。 |
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| AbstractList | 目的 比较地西他滨(DAC)单药与以小剂量阿糖胞苷(Ara-C)为基础的CAG/HAG(阿克拉霉素/高三尖杉酯碱+Ara-C+G-CSF)方案治疗骨髓增生异常综合征(MDS)难治性贫血伴有原始细胞增多(RAEB)的疗效及安全性.方法 回顾性分析2008年12月至2016年10月中国医学科学院血液病医院MDS诊疗中心121例MDS-RAEB患者临床资料,其中59例接受DAC 20 mg·m-2·d-1×5 d方案治疗,62例接受CAG/HAG方案治疗,比较两组患者的总反应率(ORR)、总生存(OS)率及不良反应发生率.结果 DAC组、CAG/HAG组患者的ORR分别为66.2%和56.4%,差异无统计学意义(χ2=1.185,P=0.276).CAG/HAG组1个疗程起效率明显高于DAC组(94.3%对69.2%),两组患者起效疗程数总体比较差异有统计学意义(χ2=7.612,P=0.009).DAC组中位OS时间为19.5(95%CI 10.5~28.4)个月,CAG/HAG组中位OS时间为20.3(95%CI 10.7~29.9)个月,两组差异无统计学意义(χ2=0.004,P=0.947).两组患者的不良反应主要是3~4级血细胞减少和相关感染,CAG/HAG组血细胞减少发生率明显高于DAC组(100.0%对64.4%,P<0.001),CAG/HAG组第3个疗程相关感染发生率明显高于DAC组(52.9%对15.2%,P=0.008).结论 DAC单药和CAG/HAG治疗MDS-RAEB的疗效相当,CAG/HAG方案起效更快,DAC单药治疗安全性更好. 【摘要】目的比较地西他滨（DAC）单药与以小剂量阿糖胞苷（Ara．C）为基础的CAG／HAG（阿克拉霉素／高二三尖杉酯碱＋Ara-C＋G—CSF）方案治疗骨髓增生异常综合征（MDS）难治性贫血伴有原始细胞增多（RAEB）的疗效及安全性。方法回顾性分析2008年12月至2016年10月中国医学科学院血液病医院MDS诊疗中心121例MDS—RAEB患者临床资料，其中59例接受DAC20mg·m^-2·d^-1×5d方案治疗，62例接受CAG／HAG方案治疗，比较两组患者的总反应率（0RR）、总生存（OS）率及不良反应发生率。结果DAC组、CAG／HAG组患者的ORR分别为66．2％和56．4％，差异无统计学意义（x^2=1．185，P=0．276）。CAG／HAG组1个疗程起效率明显高于DAC组（94．3％对69．2％），两组患者起效疗程数总体比较差异有统计学意义（x^2=7．612，P=0．009）。DAC组中位OS时间为19．5（95％CI10．5～28．4）个月，CAG／HAG组中位0s时间为20．3（95％CI10．7～29．9）个月，两组差异无统计学意义（x^2=0．004，Jp=0．947）。两组患者的不良反应主要是3~4级血细胞减少和相关感染，CAG／HAG组血细胞减少发生率明显高于DAC组（100．0％对64．4％，P〈0．001），CAG／HAG组第3个疗程相关感染发生率明显高于DAC组（52．9％对15．2％，P=0．008）。结论DAC单药和CAG／HAG治疗MDS．RAEB的疗效相当，CAG／HAG方案起效更快，DAC单药治疗安全性更好。 |
| Abstract_FL | Objective To observe the clinical efficacy and safety of the patients of myelodysplastic syndromes-refractory anemia with excess blasts (MDS-REAB)treated with decitabine alone or based on low dose cytarabine (Ara-C) regimen CAG/HAG [aclarubrci(ACR)/ homoharring-tonine (HHT)+cytarabine+granulocyte colony stimulating factor (G-CSF)]. Methods Totally 121 patients with MDS-REAB were retrospectively analyzed, including 59 patients treated with decitabine alone(20 mg·m-2·d-1 for 5 days), the rest 62 ones treated with low-dose Ara-C-based regimen CAG/HAG. Overall response rate(ORR), overall survival(OS)and adverse events of the two groups were analyzed and compared retrospectively. Results The ORR of decitabine alone or CAG/HAG were 66.2% and 56.4% respectively, with no statistically significant differences(χ2=1.185, P=0.276). Initial response rate detected by the end of first cycle of CAG/HAG was higher than that of decitabine alone(94.3%vs 69.2%), there was statistically significant difference in the overall comparison of two groups (χ2=7.612, P=0.009). The median OS of decitabine alone was 19.5(95%CI 10.5-28.4)months, the median OS of CAG/HAG was 20.3 (95%CI 10.7-29.9) months, with no statistically significant differences(χ2=0.004, P=0.947). Grade 3-4 cytopenia and infection were the most prevalent adverses of two group patients. Grade 3-4 cytopenia rate of CAG/HAG was higher than that of decitabine alone(100.0%vs 64.4%, P<0.001). The infection rate detected at third cycle of CAG/HAG was higher than that of decitabine alone (52.9% vs 15.2%, P=0.008). Conclusion The efficacy of treating MDS-RAEB with decitabine alone or CAG/HAG was equivalent. CAG/HAG treatment came into effect faster, but decitabine alone treatment was safer. |
| Author | 徐泽锋 秦铁军 张宏丽 方力维 张悦 潘丽娟 胡耐博 曲士强 李冰 肖志坚 |
| AuthorAffiliation | 中国医学科学院、北京协和医学院血液学研究所、血液病医院；实验血液学国家重点实验室,天津300020 |
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| Author_FL | Xiao Zhijian Hu Naibo Qu Shiqiang Fang Liwei Zhang Yue Zhang Hongli Qin Tiejun Pan Lijuan Li Bing Xu Zefeng |
| Author_FL_xml | – sequence: 1 fullname: Xu Zefeng – sequence: 2 fullname: Qin Tiejun – sequence: 3 fullname: Zhang Hongli – sequence: 4 fullname: Fang Liwei – sequence: 5 fullname: Zhang Yue – sequence: 6 fullname: Pan Lijuan – sequence: 7 fullname: Hu Naibo – sequence: 8 fullname: Qu Shiqiang – sequence: 9 fullname: Li Bing – sequence: 10 fullname: Xiao Zhijian |
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| DocumentTitleAlternate | The efficacy and safety of the patients of myelodysplastic syndromes-refractory anemia with excess blasts treated with decitabine alone or CAG/HAG regimen |
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| Keywords | 地西他滨 Treatment outcome 治疗结果 抗肿瘤联合化疗方案 药物毒性 Drug toxicity 骨髓增生异常综合征 Decitabine Antineoplastic combined chemotherapy protocols Myelodysplastic syndromes |
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| Notes | Objective To observe the clinical efficacy and safety of the patients of myelodysplastic syndromes-refractory anemia with excess blasts （MDS-REAB）treated with decitabine alone or based on low dose cytarabine （Ara-C） regimen CAG/HAG [aclarubrci （ACR） / homoharring- tonine （HHT）＋cytarabine＋granulocyte colony stimulating factor （G-CSF） ]. Methods Totally 121 patients with MDS-REAB were retrospectively analyzed, including 59 patients treated with decitabine alone （20 mg·m^-2. d^-1 for 5 days）, the rest 62 ones treated with low-dose Ara-C-based regimen CAG/HAG. Overall response rate （ORR）, overall survival （OS） and adverse events of the two groups were analyzed and compared retrospectively. Results The ORR of decitabine alone or CAG/HAG were 66.2% and 56.4% respectively, with no statistically significant differences （x^2=1.185, P=0.276）. Initial response rate detected by the end of first cycle of CAG/HAG was higher than that of decitabine alone （94.3% vs 69.2% ）, there was statistically significant difference in t |
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| PublicationTitle | 中华血液学杂志 |
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| PublicationYear | 2017 |
| Publisher | 300020 天津,中国医学科学院、北京协和医学院血液学研究所、血液病医院,实验血液学国家重点实验室 |
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| Snippet | 【摘要】目的比较地西他滨（DAC）单药与以小剂量阿糖胞苷（Ara．C）为基础的CAG／HAG（阿克拉霉素／高二三尖杉酯碱＋Ara-C＋G—CSF）方案治疗骨髓增生异常综合征（MDS）难治... 目的 比较地西他滨(DAC)单药与以小剂量阿糖胞苷(Ara-C)为基础的CAG/HAG(阿克拉霉素/高三尖杉酯碱+Ara-C+G-CSF)方案治疗骨髓增生异常综合征(MDS)难治性贫血伴有原始细胞增... |
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| SubjectTerms | 地西他滨 抗肿瘤联合化疗方案 治疗结果 药物毒性 骨髓增生异常综合征 |
| Title | 地西他滨单药与CAG／HAG方案治疗难治性贫血伴有原始细胞增多的疗效和安全性比较 |
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