摘要
目的分析维奈克拉(VEN)联合阿扎胞苷(AZA),与地西他滨(DAC)联合预激方案(CAG)对老年复发急性髓系白血病(AML)的治疗效果。方法回顾性分析南阳市中心医院2019年1月至2022年3月期间收入的70例老年复发AML患者,其中31例患者采取DAC联合CAG方案治疗(对照组),39例患者采取VEN联合AZA治疗(研究组)。观察两组患者有效率、治疗前后血液各项情况、免疫功能及治疗后出现的不良反应。结果治疗前两组血液指标、免疫功能差异无统计学意义(P>0.05);研究组治疗缓解率(79.49%)高于对照组(41.94%);治疗后研究组血小板计数、白细胞计数均高于对照组,骨髓原始细胞比例低于对照组;治疗后两组患者免疫功能均出现好转,研究组下降幅度更大;研究组白细胞减少、血红蛋白减少、血小板减少、感染、乏力、恶心呕吐、腹痛、低钾血症发生率均低于对照组,差异有统计学意义(P<0.05)。结论老年复发急性髓系白血病经维奈克拉联合阿扎胞苷治疗,缓解率更高,各项血液指标有一定改善,患者免疫功能明显恢复,同时治疗期间不良发应更低,安全性更高,值得应用。
Objective To analyze the therapeutic effect of venetoclax(VEN)combined with azacytidine(AZA)and decitabine(DAC)combined with CAG on elderly with relapsed acute myeloid leukemia(AML).Methods Retrospective analysis was made on 70 elderly patients with relapsed AML from January 2019 to March 2022 in Nanyang Central Hospital.Among them,31 patients were treated with DAC combined with CAG(control group),and 39 patients were treated with VEN combined with AZA(study group).The effective rate,blood conditions before and after treatment,immune function and adverse reactions of the two groups were observed.Results There was no significant difference in blood indexes and immune function between the two groups before treatment(P>0.05);The remission rate of the study group(79.49%)was higher than that of the control group(41.94%);After treatment,the platelet count and leukocyte count in the study group were higher than those in the control group,and the proportion of bone marrow primordial cells was lower than that in the control group;After treatment,the immune function of patients in both groups improved,and that of the study group decreased more significantly;The incidence of leukopenia,hemoglobin reduction,thrombocytopenia,infection,fatigue,nausea and vomiting,abdominal pain,and hypokalemia in the study group were lower than those in the control group,with a statistically significant difference(P<0.05).Conclusion The remission rate of elderly patients with relapsed acute myeloid leukemia treated with VEN combined with AZA is higher,various blood indicators have been improved to some extent,and the immune function of the patients has been significantly restored.At the same time,the adverse events during treatment should be lower,and the safety is higher,which is worthy of application.
作者
王妮
WANG Ni(Department of Hematology,Nanyang Central Hospital,Nanyang Henan 473000,China)
出处
《临床研究》
2022年第11期80-83,共4页
Clinical Research
