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目的观察并分析地西他滨联合小剂量化疗对骨髓增生异常综合征-难治性贫血伴原始细胞增多(MDS-RAEB)患者疗效及生存期的改善作用。方法对89例MDS-RAEB患者的临床资料进行回顾性分析。根据治疗方法不同将患者分为地西他滨组、化疗组和联合组。依据IWG疗效评价标准比较三组患者的治疗效果,并根据随访结果进行生存分析,计算比较三组患者的中位生存时间。结果联合组完全缓解、部分缓解、骨髓缓解、血液学改善及总反应率的比例明显高于另外两组(P<0.05),疾病稳定和治疗失败的比例明显低于另外两组(P<0.05);联合组的中位生存时间为24.4个月,明显高于地西他滨组(17.1个月)和化疗组(15.2个月),P<0.05;患者对地西他滨联合小剂量化疗方法整体具有较好的耐受性。结论地西他滨联合小剂量化疗的方法可以提升MDS-RAEB患者的临床治疗效果,延长生存期,是一种有效的临床治疗方案。
Objective To observe and analyze the effect of decitabine combined with low-dose chemotherapy on the efficacy and survival of patients with myelodysplastic syndrome-refractory anemia with proliferative myelocytosis (MDS-RAEB). Methods The clinical data of 89 patients with MDS-RAEB were retrospectively analyzed. According to different treatment methods, patients were divided into decitabine group, chemotherapy group and combination group. According to IWG curative effect evaluation criteria, the curative effects of three groups of patients were compared. Survival analysis was performed according to the follow-up results. The median survival time was calculated and compared among the three groups. Results The ratio of complete remission, partial remission, bone marrow remission, hematological improvement and total response rate in the combined group was significantly higher than that in the other two groups (P <0.05), and the ratio of stable disease and failed treatment was significantly lower than that in the other two groups (P <0.05 ). The median survival time in the combination group was 24.4 months, which was significantly higher than that in the decitabine group (17.1 months) and the chemotherapy group (15.2 months), P <0.05. The method as a whole has better tolerability. Conclusion Decitabine combined with low-dose chemotherapy can improve the clinical efficacy and prolong the survival of patients with MDS-RAEB, which is an effective clinical treatment.