文章摘要

全反式维甲酸、α干扰素联合小剂量阿糖胞苷治疗低增生性急性髓性白血病的疗效

作者: 1李艳秋, 1丁超
1 遂宁市中心医院血液科，四川 遂宁 629000
通讯: 李艳秋 Email: lyq2009lovelove@163.com
DOI: 10.3978/j.issn.2095-6959.2022.12.006
基金: 四川省卫生和计划生育委员会科研课题(17PJ432)。

摘要

目的：观察全反式维甲酸、α干扰素联合小剂量阿糖胞苷治疗低增生性急性髓性白血病(acute myeloid leukemia，AML)的临床疗效。方法：回顾性收集2018年2月至2021年2月遂宁市中心医院诊治的低增生性AML患者的临床资料，共76例。根据患者自愿选择的治疗方法不同分为对照组与治疗组，对照组34例，予以小剂量阿糖胞苷治疗；治疗组42例，在对照组基础上予以全反式维甲酸、α干扰素治疗。比较两组临床疗效、不良反应及随访6个月生存情况，并观察治疗前后血清碱性成纤维细胞生长因子(basic fibroblast growth factor，bFGF)、转化生长因子(transforming growth factor β1，TGF-β1)、血管内皮生长因子(vascular endothelial growth factor，VEGF)表达情况。结果：治疗组患者临床治疗有效率为73.81%，高于对照组的50.00%(P<0.05)。与治疗前相比，两组患者治疗后血清bFGF、VEGF表达均明显降低，TGF-β1表达明显升高，且治疗组bFGF、VEGF表达均明显低于对照组，TGF-β1表达明显高于对照组(均P0.05)。治疗组患者30 d病死率明显低于对照组(P<0.05)，两组患者6个月生存率比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论：全反式维甲酸、α干扰素联合小剂量阿糖胞苷治疗低增生性AML疗效确切，能调节患者血清bFGF、TGF-β1及VEGF表达，改善近期预后，安全性好。
关键词： 低增生性急性髓性白血病；全反式维甲酸；α干扰素；阿糖胞苷；疗效

Clinical effect of all-trans retinoic acid and interferon-α combined with low-dose cytarabine in the treatment of hypoproliferative acute myeloid leukemia

Authors: 1LI Yanqiu, 1DING Chao
1 Department of Hematology, Suining Central Hospital, Suining Sichuan 629000, China

CorrespondingAuthor: LI Yanqiu Email: lyq2009lovelove@163.com

DOI: 10.3978/j.issn.2095-6959.2022.12.006

Foundation: This work was supported by the Scientific Research Project of Sichuan Health and Family Planning Commission, China (17PJ432).

Abstract

Objective: To study the clinical effect of all-trans retinoic acid and interferon-α combined with low-dose cytarabine in the treatment of hypoproliferative acute myeloid leukemia (AML). Methods: The clinical data of 76 patients with hypoproliferative AML diagnosed and treated in the Suining Central Hospital from February 2018 to February 2021 was retrospectively analyzed. The patients were divided into a control group (34 cases) and a treatment group (42 cases) according to the treatment method. Patients in the control group were treated with low-dose cytarabine, while those in the observation group were treated with all-trans retinoic acid and interferon-α combined with low-dose cytarabine. The clinical effect, adverse reactions, and 6-month survival were compared between the 2 groups. The expression of serum basic fibroblast growth factor (bFGF), transforming growth factor β1 (TGF-β1), and vascular endothelial growth factor (VEGF) was observed. Results: The clinical treatment effective rate in the treatment group (73.81%) was higher than that in the control group (50.00%) (P<0.05). After the treatment, the expression of serum bFGF and VEGF significantly decreased, and the expression of TGF-β1 significantly increased in the 2 groups. The expression of bFGF and VEGF in the treatment group was significantly lower than that in the control group, and the expression of TGF-β1 was significantly higher than that in the control group (all P<0.05). The median survival time was 16.3 months in the treatment group and 7.8 months in the control group. There was no significant difference between the 2 groups (P>0.05). The 30 d mortality rate in the treatment group was significantly lower than that in the control group (P<0.05), but there was no significant difference in 6-month survival rate between the 2 groups (P>0.05). There was no significant difference in the incidence of adverse reactions between the 2 groups (P>0.05). Conclusion: All-trans retinoic acid and interferon-α combined with low-dose cytarabine is effective in the treatment of hypoproliferative AML, which can regulate the expression of serum bFGF, TGF-β1, and VEGF, and improve short-term prognosis with good safety.

Keywords： hypoproliferative acute myeloid leukemia; all-trans retinoic acid; interferon-α; cytarabine; curative effect

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