摘要
目的分析地西他滨联合CAG方案(阿糖胞苷+阿克拉霉素+粒细胞集落刺激因子,DCAG方案)联合程序性死亡受体1(PD-1)抑制剂(替雷利珠单抗或信迪利单抗)治疗复发/难治性急性髓性白血病(AML)的临床疗效。方法收集徐州医科大学附属医院2018年1月—2021年5月诊断为复发/难治性AML的患者58例,其中DCAG方案组40例,PD-1抑制剂联合DCAG方案(P-DCAG)组18例,比较2组的客观缓解率(ORR)、并发症、生化指标及预后情况。结果P-DCAG组中化疗次数≥5次的患者比例较DCAG组高,未接受移植的患者比例较DCAG组低,差异有统计学意义(P<0.05)。2组ORR、完全缓解(CR)、部分缓解(PR)、未缓解(NR)、1年无进展生存率、中位生存期和中位无进展生存期的差异均无统计学意义(P>0.05)。P-DCAG组的中位生存期为17个月,而DCAG组为11个月。P-DCAG组的1年总生存率(77.78%)较DCAG组(52.50%)高(P<0.05)。在≥60岁的患者中,P-DCAG组的无进展生存期比DCAG组长,差异有统计学意义(P<0.05)。P-DCAG组骨髓抑制发生率较DCAG组低(P<0.001)。结论相较于DCAG方案,P-DCAG方案可以改善患者的总体预后,为老年AML的治疗提供了一种可能的选择。
Objective To analyze the clinical effectiveness of decitabine combined with CAG regimen(cytanabine+acclarithromycin+granulocyte colony-stimulating factor,DCAG regimen)and programmed death receptor 1(PD-1)inhibitor(tirelizumab or sindilizumab)in the treatment of relapsed/refractory acute myeloid leukemia(AML).Methods A total of 58 patients who were diagnosed with relapsed/refractory AML in the Affiliated Hospital of Xuzhou Medical University from January 2018 to May 2021 were enrolled.They were divided into two groups:a decitabine combined with CAG(DCAG)regimen group(n=40),and a PD-1 inhibitor combined with DCAG regimen(P-DCAG)group(n=18).The objective response rate(ORR),complications,biochemical indicators and prognosis of the two groups were compared between the two groups.Results In the P-DCAG group,the proportion of patients who received chemotherapy≥five times was significantly higher than that in the DCAG group,while the proportion of patients not receiving transplantation was significantly lower than that in the DCAG group(P<0.05).There were no significant differences in ORR,complete response(CR),partial response(PR),no response(NR),1-year progression-free survival,median overall survival and median progression-free survival between the two groups(P>0.05).The mean survival time was 17 months for the P-DCAG group and 11 months for the DCAG group.The 1-year overall survival rate in the P-DCAG group(77.78%)was higher than that in the DCAG group(52.50%).For patients aged≥60 years,the progression-free survival(PFS)of the P-DCAG group was remarkably longer than that of the DCAG group(P<0.05).The P-DCAG group had a lower incidence of myelosuppression than the DCAG group(P<0.001).Conclusions Compared with DCAG regimen,P-DCAG regimen may improve the overall prognosis of patients,providing a possible option for the treatment of AML.
作者
张芊芊
韩倩楠
程海
曹江
齐昆明
李振宇
徐开林
陈伟
ZHANG Qianqian;HAN Qiannan;CHENG Hai;CAO Jiang;QI Kunming;LI Zhenyu;XU Kailin;CHEN Wei(Department of Hematology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)
出处
《徐州医科大学学报》
CAS
2022年第9期630-635,共6页
Journal of Xuzhou Medical University
基金
江苏省自然科学基金面上项目(BK18661177)
中国博士后科学基金(2018T110557)。
