首页> 中文期刊>济宁医学院学报 >三氧化二砷联合沙利度胺治疗中危-1型骨髓增生异常综合征疗效观察

三氧化二砷联合沙利度胺治疗中危-1型骨髓增生异常综合征疗效观察

     

摘要

Objective To investigate the treatment effect and adverse effect of Arsenic Trioxide(As2O3) combined with thalidomide regime for patients with IPSS intermediate-1 myelodysplastic syndromes ( MDS) . Methods 102 patients with definite IPSS intermediate-1 MDS of our hospital were randomly divided into the treatment group and the control group with 51cases in each group.In the treatment group,As2 O3 combined with thalidomide was used,while in the control group traditional promoting hematopoietic and immunomodu-latory was selected which was stanozolol combined with thalidomide.The same supportive treatment was giv-en in each group,which was transfusing platelet suspension or red blood cells to those with platelet of <20 × 109 or HB of<70g/L, and other treatments.The patients in both group were treated for two courses.The blood test,liver function test,renal function test and other adverse reaction were monitored.Results The to-tal of 62.7%of patients showed hematological improvement ( HI) in the treatment group,while the total of 52%of patients in the control group.There was significantly difference in the two groups (P<0.05).4 pa-tients had adverse reaction in the treatment group and 3 patients in the control group.There was no serious adverse reaction in both groups.No difference in the two groups appeared (P>0.05).Conclusion As2O3 combined with thalidomide could increase the total rate of hematological improvement in the patients with intermediate-1 myelodysplastic obviously,which was an effective treatment for intermediate-1 MDS without additional adverse reaction.%目的:评价三氧化二砷联合沙利度胺治疗中危-1型骨髓增生异常综合征( MDS)的临床疗效及不良反应。方法选取2006年1月至2016年1月于我院初治原发中危-1型MDS患者102例,随机分成治疗组和对照组,每组51例,治疗组予以三氧化二砷联合沙利度胺治疗2疗程,对照组采用传统的促造血联合免疫调节治疗,即司坦唑醇联合沙利度胺治疗2疗程,两组患者均给予相同的支持治疗,如血小板<20×109/L予以输注单采血小板,血红蛋白( HB)<70g/L时予以输注红细胞等。观察两组患者血常规变化、肝肾功能指标及其他不良反应。结果治疗组血液学改善( HI)率为62.7%,对照组HI率为52%,两组差异有统计学意义( P<0.05)。不良反应治疗组7例,对照组6例,两组患者均未出现严重不良反应,差异无统计学意义(P>0.05)。结论三氧化二砷联合沙利度胺的治疗方案明显提高中危-1型MDS患者的血液学改善,是治疗中危-1型骨髓增生异常综合征的有效方法,且不增加治疗相关不良反应。

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