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目的回顾性分析超低剂量地西他滨(decitabine,DAC)序贯减量CAG方案治疗中高危骨髓增生异常综合征(myelodysplastic syndrome,MDS)的近期临床疗效及安全性。方法收集本院血液科2015年4月-2016年10月收治的30例中高危骨髓增生异常综合征患者,其中男23例,女7例,中位年龄61(50~81)岁,均接受超低剂量DAC序贯减量CAG方案治疗,观察临床疗效、不良事件和生存时间。结果 30例中16例(53%)获完全缓解(complete remission,CR),5例(17%)获部分缓解(partial remission rate,PR),3例(10%)获血液学改善(hematological improvement,HI),6例(20%)治疗无效(total failure,TF),总反应率(overall response rate,ORR)为80%;中位生存时间11(2~18)个月,24例存活,6例死亡。15例(50%)治疗中出现感染,其中2例(7%)重症感染。结论超低剂量DAC序贯减量CAG方案治疗中高危MDS老年患者疗效稳定,重症感染及血液学不良反应发生率低,耐受性好,提示可在临床进一步推广。
Objective To retrospectively analyze the short-term clinical efficacy and safety of ultra-low dose decitabine (DAC) sequential reduction CAG regimen in the treatment of middle-high risk myelodysplastic syndrome (MDS). Methods Thirty patients with moderate to high risk myelodysplastic syndrome were enrolled from April 2015 to October 2016 in our department of hematology, including 23 males and 7 females, with a median age of 61 (50-81 years) Ultra-low dose DAC sequential reduction of CAG regimen treatment, observation of clinical efficacy, adverse events and survival time. Results Complete remission (CR) was achieved in 16 (53%) of the 30 patients, partial remission rate (PR) in 5 patients (17%) and hematological improvement in 3 patients (10%) , HI), 6 cases (20%) had total failure (TF) and overall response rate (ORR) was 80%. The median survival time was 11 (2- 18) 6 died. Fifteen patients (50%) had infections during treatment, with two (7%) severe infections. Conclusion Ultra-low dose DAC sequential reduction of CAG regimen in the treatment of elderly patients with high-risk MDS stable effect, severe infection and low incidence of hematological adverse reactions, tolerability, suggesting that further clinical application.