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目的:分析国产地西他滨联合减量IAG方案[粒细胞集落刺激因子(G-CSF)+伊达比星(IDA)+阿糖胞苷(Ara-C)]在治疗骨髓增生异常综合征(myelodysplastic syndrome,MDS)及其转化急性髓细胞白血病(acute myeloid leukemia,AML)患者中的临床疗效及其安全性。方法:选取2014年10月至2016年5月收治的中高危MDS以及AML(MDS转化)患者共20例,应用国产地西他滨联合减量IAG方案治疗,观察临床疗效及不良反应发生情况。结果:20例患者至少进行2疗程化疗,完全缓解者9例,部分缓解5例,总有效率为70%(14/20)。所有患者均出现III-IV级血液学毒性,第1、2疗程粒细胞缺乏及III、IV级血小板减少持续时间无统计学差异(P>0.05)。年龄≥60岁患者粒细胞缺乏时间更长,与年龄<60岁患者相比差异有统计学意义(P<0.05),所有患者非血液学不良反应均可耐受。染色体核型预后良好者疗效佳,预后不良者预后差,患者的年龄、性别与疗效无显著相关性。结论:地西他滨联合减量IAG方案治疗MDS和AML疗效显著,不良反应可控,耐受性较好,值得在临床上进一步推广。
OBJECTIVE: To analyze the efficacy and safety of decitabine combined with IAG regimen [G-CSF + IDA + Ara-C] in the treatment of myelodysplastic syndrome To investigate the clinical efficacy and safety of myelodysplastic syndrome (MDS) and its patients with acute myeloid leukemia (AML). Methods: A total of 20 middle- and high-risk MDS patients and AML (MDS conversion) patients were enrolled in the study from October 2014 to May 2016. They were treated with decitabine plus IAG regimen. The clinical efficacy and adverse reactions were observed. Results: Twenty patients underwent at least 2 cycles of chemotherapy, with 9 cases of complete remission and 5 cases of partial remission. The total effective rate was 70% (14/20). All patients had grade III-IV hematologic toxicity. There was no significant difference in duration of neutropenia and grade III and IV thrombocytopenia between the first and second courses (P> 0.05). Patients aged> 60 years had longer agranulocytosis than those of patients <60 years of age (P <0.05). All patients were tolerant to non-hematologic adverse reactions. Good prognosis of chromosome karyotype good curative effect, poor prognosis of patients with poor prognosis, the patient’s age, sex and efficacy were not significantly correlated. Conclusion: Decitabine combined with IAG regimen has significant curative effect on MDS and AML, with controlled adverse reactions and good tolerability. It is worth further promotion in clinic.