解放军医学杂志2018，Vol.43Issue(3)：239-243,5.DOI:10.11855/j.issn.0577-7402.2018.03.11
骨髓增生异常综合征患者淋巴细胞绝对值计数与地西他滨治疗反应的关系
The absolute value of lymphocyte counts and the response to decitabine treatment in patients with myelodysplastic syndrome
庞艳彬 1赵松颖 1薛华 1郭慧梅 1化罗明 1范丽霞 1罗建民 2杜欣3
作者信息
- 1. 071000 河北保定 河北大学附属医院血液内科
- 2. 050000 石家庄 河北医科大学第二医院血液内科
- 3. 510080 广州 广东省人民医院/广东省医学科学院,华南理工大学医学院第一临床医院血液内科
- 折叠
摘要
Abstract
Objective To investigate the relations of absolute lymphocyte counts (ALC) to the therapeutic responses in patients with myelodysplastic syndrome (MDS) after the first course of decitabine (DAC) treatment.Methods Clinical data of 35 patients with MDS and MDS-derived secondary acute myeloid leukemia (AML) who were admitted in the Affiliated Hospital of Hebei University from Jan.2014 to Dec.2016 and treated with DAC were included in the present study.The patients were grouped into high lymphocyte group (H-Lym,ALC ≥ 1.2 × 109/L) and low lymphocyte group (L-Lym,ALC＜1.2 × 109/L) based on the ALC in days 28-35 after the first course of DAC treatment.The baseline data of both groups were compared with Pearson x2 analysis,while t test was used to analyze the changes of lymphocyte number before and after the first course of DAC treatment.Progressionfree survival (PFS) was estimated with Kaplan-Meier method,and the cumulative survival (CS) was compared between the two groups using log-rank test.Results Of the 35 patients,15 were in H-Lym group and 20 in L-Lym group.No significant difference existed in the baseline lymphocyte levels between the two groups (P＞0.05).The statistically significant differences (P＜0.05) existed only in the patients of the two groups who were with the proportion of bone marrow blasts ≥ 10％.The ALC in H-Lym group were slightly higher after the first course of DAC treatment than that at the time of diagnosis,but with no statistically significant (P＞0.05).However,the ALC in L-Lym group were significantly lower after the first course of DAC treatment than that at the time of diagnosis (P＜0.05).Patients had higher overall response rate (ORR) in H-Lym group than in L-Lym group (80％ vs.40％,P＜0.05).The median PFS was 10 months in H-Lym group and 7.6 months in L-Lym group (P＜0.05).Univariate analysis showed that the low ALC was a poor prognostic factor for the progression ofMDS (P＜0.05).Conclusion Patients with ALC ≥ 1.2 × 109/L after the first course of DAC treatment will have better ORR and longer PFS.关键词
地西他滨/骨髓增生异常综合征/淋巴细胞/无进展生存期Key words
decitabine/myelodysplastic syndromes/lymphocyte/progression-free survival分类
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庞艳彬,赵松颖,薛华,郭慧梅,化罗明,范丽霞,罗建民,杜欣..骨髓增生异常综合征患者淋巴细胞绝对值计数与地西他滨治疗反应的关系[J].解放军医学杂志,2018,43(3):239-243,5.
