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目的:总结超小剂量地西他滨治疗骨髓增生异常综合征(MDS)临床疗效与安全性。方法:回顾性分析皮下注射地西他滨(5~7mg·m~(-2)·d~(-1),d1~3,8,15,22,6周为1个疗程)治疗16例MDS患者的疗效和不良反应。结果:2例(12.5%)获完全缓解,2例(12.5%)获部分缓解并脱离成分血输注,5例(31.3%)达血液学改善,5例(31.3%)病情稳定,总反应率87.5%。Ⅳ级血液学毒性发生率2例(12.5%),Ⅲ~Ⅳ级感染发生率4例(25.0%),无Ⅲ~Ⅳ级出血、恶心呕吐和肝功能损伤。中位随访时间15.5(6~27)个月,随访期间1例死亡。结论:超小剂量地西他滨可以有效治疗MDS,严重血液学毒性和早期病死发生率低。
Objective: To summarize the clinical efficacy and safety of ultra-low dose decitabine in the treatment of myelodysplastic syndrome (MDS). Methods: A retrospective analysis of decitabine decitabine (5 ~ 7mg · m ~ (-2) · d ~ (-1), d1 ~ 3,8,15,22, 6 weeks for a course of treatment) in 16 cases Efficacy and adverse reactions in patients with MDS. Results: Two patients (12.5%) achieved complete remission. Two patients (12.5%) were partially relieved and separated from blood transfusions. Five patients (31.3%) achieved hematological improvement and five patients (31.3% Rate of 87.5%. Ⅳ grade hematological toxicity in 2 cases (12.5%), Ⅲ ~ Ⅳ infection in 4 cases (25.0%), no grade Ⅲ ~ Ⅳ hemorrhage, nausea and vomiting and liver damage. The median follow-up time was 15.5 (ranged from 6 to 27) months, with one death during follow-up. Conclusion: Ultra low dose of decitabine can effectively treat MDS with severe hematological toxicity and low incidence of early death.