地西他滨与环孢素治疗低危性骨髓增生异常综合征对照观察

摘要

Objective To compare the curative effect and safety between decitabine and ciclosporin in the treatment of low-risk myelodysplastic syndrome (MDS).Methods Thirty-one low-risk MDS patients were assigned to decitabine (n=14) and ciclosporin group (n=17) according to treatment schemes, the former was treated with low-dose decitabine and the latter with ciclosporin, and they were followed up for 1 year.Total effective rates, the incidences of adverse reactions and survival rates during 1 year follow-up were compared between 2 groups.Results Total effective rate was 35.7% in decitabine and 64.7% in ciclosporin group and group difference had no statistical significance (P>0.05).Adverse reactions were myelosuppression (n=5), pulmonary infection (n=5) and abdominal infection (n=3) in decitabine and pulmonary infection (n=1) in ciclosporin group.Survival rate was 78.6% in decitabine and 100% in ciclosporin group during 1 year follow-up and the former significantly lower than the latter (P<0.05).Conclusion Decitabine has equivalent efficacy to ciclosporin in treating low-risk MDS, but causes such adverse reactions as myelosuppression etc.easily, patients' tolerances are poor, and survival rate within 1 year is lower.%目的 比较地西他滨与环孢素治疗低危性骨髓增生异常综合征的临床疗效及安全性. 方法 将31例低危性骨髓增生异常综合征患者按治疗方案分为地西他滨组14例,环孢素组17例,前者给予低剂量地西他滨治疗,后者给予环孢素治疗,随访1 a.观察比较两组患者临床总有效率、不良反应发生率及随访1 a生存率.结果 地西他滨组总有效率为35.7%,环孢素组为64.7%,两组比较差异无统计学意义(P>0.05).地西他滨组不良反应表现为骨髓抑制(5例)、肺部感染(5例)、腹腔感染(3例),环孢素组表现为肺部感染(1例).地西他滨组随访1 a生存率为78.6%,环孢素组为100%,地西他滨组显著低于环孢素组(P<0.05).结论 地西他滨治疗低危性骨髓增生异常综合征疗效与环孢素无明显差异,但更易引起骨髓抑制等不良反应,患者耐受性较差、1 a内生存率较低.