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黄桂琴.急性髓系白血病巩固治疗阿糖胞苷剂量与骨髓抑制程度相关性分析[J].内科急危重症杂志,2025,31(2):130-134
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| DOI：10.11768/nkjwzzzz20250207 |
| 中文关键词: 急性髓系白血病 巩固治疗 阿糖胞苷 血小板减少 粒细胞缺乏症 |
| 英文关键词: |
| 基金项目:国家自然科学基金（82270177） |
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| 摘要点击次数: 85 |
| 全文下载次数: 120 |
| 中文摘要: |
| 摘要 目的：探究急性髓系白血病（AML）巩固治疗阿糖胞苷剂量与骨髓抑制程度的相关性。方法：回顾性分析141例AML患者的临床特征及实验室检查结果，筛选标准为初诊原发性AML，经1~2次诱导化疗取得形态学完全缓解，在院行缓解后第一次巩固治疗且治疗期间未复发。按巩固治疗方案阿糖胞苷剂量分为高剂量（1~3g/m2 q12h×6次）和低剂量（100mg/m2×5~7d或10mg/m2q12h×7~14d）阿糖胞苷组，探究影响AML患者巩固治疗期间血小板减少以及粒细胞缺乏的因素。结果：高剂量阿糖胞苷组出现3~4级血小板减少及粒细胞缺乏症的比例高于低剂量阿糖胞苷组，出现的时间早于低剂量阿糖胞苷组（P均＜0.01）。2组在3~4级血小板减少及粒细胞缺乏症持续时间方面比较，差异无明显统计学意义（P均>0.05）。年龄及巩固治疗前外周血小板计数是影响患者3~4级血小板减少及粒细胞缺乏症持续时间的独立因素。结论：AML巩固治疗阿糖胞苷剂量不影响3~4级血小板减少和粒细胞缺乏症持续时间，高剂量阿糖胞苷组巩固治疗更早出现血小板减少和粒细胞缺乏，有利于缩短住院时间从而节约医疗资源。 |
| 英文摘要: |
| Abstract Objective: To investigate the correlation between the dose of cytarabine and the degree of myelosuppression in consolidation therapy for acute myeloid leukemia (AML). Methods: Clinical features and laboratory investigations of 141 AML patients were retrospectively analyzed, and the screening criteria were as follows: first diagnosis of primary AML, complete morphological remission achieved by 1-2 induction chemotherapy treatments, first consolidation treatment after remission at our hospital and no relapse during treatment. According to the dose of cytarabine in the consolidation regimen, the patients were divided into high-dose cytarabine group (q12h 1-3g/m2×6 times)and low-dose cytarabine group (100mg/m2×5-7d or 10mg/m2 q12h×7-14d) to investigate the factors affecting thrombocytopenia as well as granulocyte deficiency during consolidation therapy in AML patients. Results: High-dose cytarabine group showed a higher proportion of grade 3 or higher thrombocytopenia and agranulocytosis than low-dose cytarabine group, and both of them appeared earlier than low-dose cytarabine group (all P< 0.001). There was no significant difference between the high-dose cytarabine group and the low-dose cytarabine group in terms of the duration of grade 3 or higher thrombocytopenia and agranulocytosis. Age and peripheral platelet count before consolidation therapy were independent factors influencing the duration of grade 3 or higher thrombocytopenia and agranulocytosis in patients. Conclusion: AML consolidation therapy with cytarabine dose did not affect the duration of grade 3 or higher thrombocytopenia and agranulocytosis, and thrombocytopenia and agranulocytosis appeared earlier in the high-dose cytarabine group on consolidation therapy, which contributed to the shortening of hospitalization and thus the saving of healthcare resources. |
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