Objective: To investigate the efficacy and safely of DAC and CAG/HAG preexcitation chemotherapy regimens for the treatment of patients with MDS-RAEB (refractory anemia with excess blasts, RAEB).
Methods: The clinical data of 86 MDS-RAEB patients were analyzed retrospectively from February 2014 to February 2018. According to therapeutic regimem, the 86 patients were divided into 2 groups: group A (41 patients) with DAC preexcitation chemotherapy regimen, and group B (45 patients) with CAG/HAG preexcitation chemotherapy regimen; and the disease control effect, effective treatment course, median survival time and incidence of adverse reactions were compared between these 2 groups.
Results: The CR rate and ORR rate were not significantly different between these 2 groups (P＞0.05). The mCR rate in group A was significantly higher than that in group B (P＜0.05). The numbers of cases obtained therapeutic efficacy at 2 rd and 3 rd conrse in group A significantly more than those in group B (P＜0.05), but the number of cases obtained efficacy at 1 st course in group B was significantly higher than that in group A (P＜0.05). The median OS time was not significanly different between 2 groups (P＞0.05). The duration of neutrophils deficiency in group A was significantly shorter than that in group B (P＜0.05). The transfusion volume of red blood cells and platelets in group A was significantly less than that of group B (P＜0.05). The incidence of neutropenia, anemia and thrombocytopenia of III-IV grade at different treatment courses of group A were significantly lower than that in group B (P＜0.05). The incidence of infection of III-IV grade in group A at 3rd treatment course was significantly lower than that in group B (P＜0.05).
Conclusion: Preexcitation chemotherapy regimens of DAC and CAG/HAG for the treatment of MDS-RAEB possess the same effects for disease control; application of DAC regimen can efficiently reduce the risk of adverse reaction, but CAG/HAG regimen can be helpful to accelerate the effective process of treatment.
题目: 两种预激化疗方案治疗MDS-RAEB患者的临床疗效对比研究.
目的: 探讨地西他滨（DAC）和CAG/HAG预激化疗方案治疗骨髓增生异常综合征（MDS）难治性贫血合并原始细胞增多（RAEB）的疗效及其安全性的差异.
方法: 回顾性分析本院2014年2月- 2018年2月收治MDS-RAEB患者共86例临床资料。在86例中41例采用DAC方案，设为A组，而其余45例采用CAG/HAG方案，设为B组；比较2组的疾病控制效果、起效疗程、中位生存时间及不良反应的发生率.
结果: 2组患者CR率和ORR率比较差异无显著性（P＞0.05）；A组mCR率显著高于B 组（P＜0.05）；A组第2、3疗程显效病例数显著多于B组，但第1疗程显效的病例数在B组多于A组（P＜0.05）；2组患者中位 OS 比较差异无显著性（P＞0.05）；A组粒细胞缺乏持续时间显著短于B组（P＜0.05）；A组红细胞和血小板输注量均显著少于B组（P＜0.05）；A组不同疗程时3-4级中性粒细胞缺乏、贫血及血小板减少发生率均显著低于B组（P＜0.05）；A组第3疗程时3-4级感染发生率显著低于B组（P＜0.05）.
结论: DAC和CAG/HAG预激化疗方案用于MDS难治性贫血合并RAEB患者的总体病情控制效果接近，但DAC方案能使不良反应的风险更低，而CAG/HAG方案起效更快.