CAG及CAG联合地西他滨化疗方案治疗老年急性髓系白血病的疗效比较

摘要

Objective To compare the curative effect of CAG regimen and CAG combined with decitabine regimen in elderly patients with acute myeloid leukemia(AML).Methods Seventy-six de novo elderly patients with AML who were diagnosed in our hospital were analyzed by a retrospective analysis.The 76 cases were divided into groups with CAG group and CAG+DAC group according to different chemotherapies.We compared the differences of complete remission rate,overall response rate,median overall survival and median relapse-free survival in two groups. Results CAG group of 49 cases:CR rate was 51.0％,ORR was 61.2％;CAG+DAC group of 27 cases:CR rate was 59.3％,ORR was 77.8％.The statistics analysis showed no significant differences in CR rate and ORR between two groups(P > 0.05 ).There were differences in median OS (10.0 months vs 12.0 months)and median RFS (8.0 months vs 11.0 months )in two groups(P >0.05).But in the high-risk group of patients,CR rate and ORR of the CAG+DAC group were higher than those of CAG group,respectively (57.1％ vs 15％;71.4％ vs 25％),the difference was statistically significant(P 0.05).Conclusion CAG regimen is similar with CAG+DAC regimen in the clinical curative effect,but CAG+DAC regimen is better in the elderly patients with AML with poor prognosis.%目的 比较CAG及CAG联合地西他滨(DAC)化疗方案治疗老年急性髓系白血病(AML)的疗效.方法 回顾性分析我院诊治的老年AML患者76例,对采用CAG或CAG+DAC两种不同化疗方案做为诱导缓解方案的患者的临床疗效进行分析,分析两组在完全缓解率,总有效率,中位生存期,中位无复发生存期的差异.结果 在老年AML患者,CAG组49例,完全缓解率为51.0％,总有效率为61.2％,CAG+DAC组27例,分别为59.3％ 和77.8％,两者完全缓解率和总有效率差异无统计学意义(P>0.05);在中位生存期(10.0个月vs 12.0个月,P=0.225)和无复发生存期(8.0个月vs 11.0个月,P=0.652)差异无统计学意义.但在高危组患者,CAG+DAC组完全缓解率,总有效率优于CAG组,分别为57.1％vs 15％;71.4％vs 25％,差异有统计学意义(P0.05),CAG+DAC组均有延长趋势.结论 CAG和CAG+DAC化疗方案临床疗效相当,但对预后差的老年AML患者,CAG+DAC在临床疗效方面显示出了优势.