| 摘要: |
| ［摘要］ 目的 比较地西他滨联合维奈克拉与地西他滨联合CAG方案治疗老年初治急性髓系白血病（AML）的临床疗效。方法 选择长江大学附属荆州医院2016年5月至2022年2月收治的不适合接受强化化疗的老年初治AML患者29例。根据患者选择治疗方案意愿将其分为维奈克拉组（地西他滨+维奈克拉，17例）与CAG组（地西他滨+CAG方案，12例）。比较两组的临床疗效及预后情况。结果 患者随访时间为8.1～70.3个月，中位随访时间为27.7个月。截至随访结束，29例患者中有8例存活，均为维奈克拉组，其中5例患者仍处于缓解阶段，行巩固治疗；3例为缓解后复发患者。19例死亡（维奈克拉组9例，CAG组10例），2例失访。维奈克拉组的完全缓解（CR）率、形态学完全缓解而血细胞计数未完全恢复（CRi）率、复合完全缓解（CR+Cri）率及总反应率（ORR）均高于CAG组，但差异无统计学意义（P>0.05）。维奈克拉组的中位总生存期（OS）为10.73个月，CAG组的中位OS为8.57个月，两组生存预后差异无统计学意义（P>0.05）。维奈克拉组的中位无进展生存期（PFS）为7.93个月，CAG组的中位PFS为5.77个月，两组复发情况差异无统计学意义（P>0.05）。29例患者中有27例（维奈克拉组16例，CAG组11例）出现了3～4级血液学不良反应。维奈克拉组与CAG组中位粒细胞缺乏时间分别为24 d和25 d，中位血小板恢复时间分别为20 d和18 d，差异均无统计学意义（P>0.05）。两组感染、出血发生率比较差异无统计学意义（P>0.05）。结论 地西他滨联合维奈克拉和地西他滨联合CAG方案对老年初治AML患者均有较好的临床疗效，且安全性良好。 |
| 关键词: 急性髓系白血病 地西他滨 CAG方案 维奈克拉 老年 |
| DOI：10.3969/j.issn.1674-3806.2022.11.13 |
| 分类号:R 733.71 |
| 基金项目: |
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| Comparison of the clinical efficacy of decitabine combined with venetoclax and decitabine combined with CAG regimen in treatment of elderly patients with newly treated acute myeloid leukemia |
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ZHANG Shi-jia, XU Xuan-xuan, TANG Yuan-yan
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Department of Hematology, Jingzhou Hospital Affiliated to Yangtze University, Hubei 434020, China
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| Abstract: |
| ［Abstract］ Objective To compare the clinical efficacy of decitabine combined with venetoclax and decitabine combined with CAG regimen in treatment of elderly patients with newly treated acute myeloid leukemia(AML). Methods Twenty-nine elderly patients with newly treated AML who were not suitable for intensive chemotherapy and were admitted to Jingzhou Hospital Affiliated to Yangtze University from May 2016 to February 2022 were selected. According to the patients′ willingness to choose the treatment plans, they were divided into venetoclax group(decitabine+venetoclax, 17 cases) and CAG group(decitabine+CAG regimen, 12 cases). The clinical efficacy and prognosis were compared between the two groups. Results The patients were followed up for 8.1-70.3 months, with a median follow-up time of 27.7 months. By the end of the follow-up, 8 of the 29 patients survived, and these survivors were in the venetoclax group, of whom 5 patients were still in remission and received consolidation therapy; 3 patients relapsed after remission. Nineteen patients died(including 9 patients in the venetoclax group and 10 patients in the CAG group), and 2 patients were lost to follow-up. The complete remission(CR) rate, morphological complete remission with incomplete blood count recovery(CRi) rate, composite complete remission(CR+Cri) rate and overall response rate(ORR) in the venetoclax group were higher than those in the CAG group, but the differences were not statistically significant(P>0.05). The median overall survival(OS) of the venetoclax group was 10.73 months, and the median OS of the CAG group was 8.57 months, and there was no significant difference in survival prognosis between the two groups(P>0.05). The median progression-free survival(PFS) of the venetoclax group was 7.93 months, and the median PFS of the CAG group was 5.77 months, and there was no significant difference in recurrence between the two groups(P>0.05). Grade 3-4 hematologic adverse reactions occurred in 27 of 29 patients(16 cases in the venetoclax group and 11 cases in the CAG group). The median time of agranulocytosis was 24 days and 25 days in the venetoclax group and the CAG group, respectively, and the median platelet recovery time was 20 days and 18 days in the venetoclax group and the CAG group, respectively, with no significant differences between the two groups(P>0.05). There were no significant differences in the incidence rates of infections and bleeding between the two groups(P>0.05). Conclusion Both decitabine combined with venetoclax and decitabine combined with CAG regimen have good clinical efficacy and good safety in elderly patients with newly treated AML. |
| Key words: Acute myeloid leukemia(AML) Decitabine CAG regimen Venetoclax Agedness |
