丁卓玲 1邓明凤 2唐元艳 3黄俊 2陈永玲 2张利铭3
作者信息
- 1. 434020 湖北省荆州市，华中科技大学同济医学院附属荆州医院药剂科
- 2. 434020 湖北省荆州市，华中科技大学同济医学院附属荆州医院检验医学部
- 3. 434020 湖北省荆州市，华中科技大学同济医学院附属荆州医院血液科
- 折叠
摘要
Abstract
Objective To investigate the clinical efficacy and safety of decitabine(DAC)combined with low - dose mitoxantrone plus cytarabine(MA)(briefly called DAC combined therapy)in the treatment of recurrent and refractory acute myeloid leukemia(AML). Methods Enrolled 12 patients with recurrent and refractory AML who were complete in the Jingzhou Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from August 2011 to May 2013. DAC combined therapy was undertaken on the patients〔intravenous drip of DAC by 20 mg·(m2 )- 1 ·d - 1 from day 1 to day 5;intravenous drip of mitoxantrone by 8 - 12 mg/ m2 from day 6 to day 8;intravenous drip of cytarabine by 100 mg/ m2 from day 6 to day 8 and on day 10〕. Before and after treatment,haematological indexes( white blood cell count,Hb and blood platelet count),the proportion of monoblasts and / or infantile monocytes among peripheral blood leukocytes,the proportion of monoblasts and / or infantile monocytes among bone marrow nucleated cells,genetic changes of bone marrow cells,chromosome abnormality rate and effective rate of cytogenetic responses. The survival status(from the end of treatment till December 2013)and adverse effects of patients were recorded. Results After treatment,Hb,blood platelet count,the proportion of monoblasts and/ or infantile monocytes among peripheral blood leukocytes,the proportion of monoblasts and/ or infantile monocytes among bone marrow nucleated cells changed significantly compared with those before treatment(P < 0. 05 ). After treatment,4(33. 3% ) patients had complete cytogenetic responses,3(25. 0% )had partial cytogenetic responses,5(41. 7% ) had no cytogenetic responses,and the hematologic overall response rate was 58. 3% (7 / 12). Among the 5(41. 7% )patients with chromosome abnormality,1 patient had complete cytogenetic responses and 2 patients had partial cytogenetic responses after treatment,with a total response rate of 60. 0% (3 / 5). Adverse effects were mainly bone marrow suppression and secondary infection,while they can be well tolerated through blood transfusion and anti - infection. The median survival time was 8. 0 months. Conclusion DAC combined therapy can achieve good efficacy in the treatment of recurrent and refractory AML in haematology and cytogenetics, and it causes rare adverse effects and well toleration. The study may provide references for clinical treatment.关键词
白血病,髓样,急性/地西他滨/米托蒽醌/阿糖胞苷/药物毒性/治疗结果Key words
Leukemia,myeloid,acute/Decitabine/Mitoxantrone/Cytarabine/Drug toxicity/Treatment outcome分类
医药卫生
