摘要
目的：探讨沙立度胺和环孢素A联合亚砷酸治疗骨髓增生异常综合征的有效性和安全性。方法：设治疗组和对照组，治疗组21例：沙立度胺每晚睡前口服，初始剂量100mg／d，然后每周剂量递增50mg／d，达最高计量200mg／d，之后改维持剂量100-200mg／d；环孢素A口服起始剂量为5．0mg／（kg·d），3个月后改维持剂量2．5～5．0mg／（kg·d）[中位3mg／（kg·d）]，亚砷酸10mg／d，静脉滴注，亚砷酸结束后15min维生素C3g／d，静脉滴注，每周5次；用4周休2周为1个疗程，以上三药均依患者耐受不良反应情况确定维持剂量并连用3～6个月。对照组16例：予雄激素、全反式维甲酸或小剂量化疗、干扰素等以及对症、支持治疗。结果：治疗组：完全缓解（CR）2例（9．52％），部分缓解（PR）5例（23．81％），血液学改善（HI）9例（42．86％），总有效率76．19%，未发现严重不良反应，常见为乏力，便秘，水肿，皮疹，肝、肾功能轻度异常等，对症处理后好转。对照组：无CR，PR2例（12．50％），HI5例（31．25％），总有效率43．75％。与治疗组比较差异有统计学意义（P〈0．05）。结论：沙立度胺和环孢素A联合亚砷酸治疗骨髓增生异常综合征有效率高，不良反应轻微，可以耐受。
Objective：To evaluate the efficacy and safety of thalidomide combined with cyclosporin A and arsenic trioxide in the treatment of myelodysplastic syndrome. Method：37 patiens were divided into 2 groups： therapy group and control group, 21 patiens were enrolled in therapy group, The initial dose of Thalidomide was 100 mg/ d, then increased 50 mg/d every week until the patients reached maximal tolerance, the maintain dose was 100- 200 mg/d. Cyclosporin A was taken 5.0 mg/（kg·d） orally in the first 3 months, then was corrected to 2.5-5. 0 mg/（kg·d）. During 4 weeks of each 6-week cycle, Arsenic trioxide was administered 10 mg/d, followed by ascorbic acid 3 g/d, ivgtt, for days 1-5/w. All patients maintain treatment 3-6 cycles. In the control group, 16 patients were administered male hormone, interferon, all-trans-retinoic acid （ATRA） or low dosage chymic therapy. Result：In the therapy group,19 （2 CR, 5 PR, 9 HI） of 21 patients had an objective response （76.19%）. The side effect was gentle inclucling fatigue, constipation, edema, tetter and abnormality of liver function and kidney function. In the control group, 7（2 PR, 5 HI） of 16 patients had an objective response （43.75%）. The response rate between two groups were significant different （ P〈0.05）. Conclusion：Thalidomide combined with cyclosporin A and arsenic trioxide in the treatment of patients with myelodysplastic syndrome was efficient and side effect was tolerable.
出处
《临床血液学杂志》
CAS
2007年第5期270-271,274,共3页
Journal of Clinical Hematology
