摘要
目的:老年急性髓系白血病(AML)存在多种不良预后因素,对标准化疗方案耐受性欠佳,低剂量阿糖胞苷不能达到满意效果,去甲基化药物对老年AML有一定疗效。因此,我们关注阿扎胞苷和地西他滨在老年AML中的应用。方法:计算机检索PubMed,Embase,Cochrane Library,OVID,Web of Science,Wanfang,CNKI等数据库,检索时限为从建库至2020年8月。收集去甲基化药物对比传统方案治疗老年AML的随机对照试验。由两位评论员按照Cochrane系统评价的方法,分别进行资料提取、质量评价,并交叉核对,使用RevMan 5.3进行Meta分析。结果:共纳入5项随机对照试验,共计1423例患者。Meta分析结果显示,与传统治疗组比较,去甲基化药物组的中位总生存延长(HR=0.80,95%CI:0.70~0.90,P=0.0003),6个月生存率(OR=1.66,95%CI:1.34~2.06,P<0.00001)、1年生存率(OR=1.60,95%CI:1.28~1.99,P<0.0001)提高,而2年生存率(OR=1.26,95%CI:0.93~1.71,P=0.13)组间比较差异无统计学意义。结论:去甲基化药物与传统治疗相比,中位总生存延长,6个月生存率、1年生存率提高,而2年生存率差异无统计学意义。
Objective:Elderly patients with acute myeloid leukemia(AML)have a variety of unfavorable prognostic factors,which are not well tolerated by standard chemotherapy regimens,and low dose cytarabine cannot achieve satisfactory results.Demethylation drugs have certain curative effect on elderly patients with AML.Therefore,we focused on the safety and efficacy of azacitidine and decitabine in elderly patients with AML.Methods:A comprehensive search was conducted until August 2020.Two reviewers collected data from patients treated with hypomethylating agents(HMAs)or traditional treatment regimen(TTR)in randomized controlled trail.Revman 5.3 software was used for data extraction and statistical analysis.Results:We identified 5 trials reported from 2010 to 2017 and randomizing 1423 patients.There was a significant advantage of median overall survival(OS)in HMAs compared with TTR(HR=0.80,95%CI:0.70-0.90,P=0.0003),a significant advantage of 6-month survival in HMAs compared with TTR(OR=1.66,95%CI:1.34-2.06,P<0.00001),and a significant advantage of 1-year survival in HMAs compared with TTR(OR=1.60,95%CI:1.28-1.99,P<0.0001).However,there was no significant difference in the 2-year OS between the 2 groups(OR=1.26,95%CI:0.93-1.71,P=0.13).Conclusion:The median OS,6-month survival and 1-year survival are significantly higher in elderly patients with AML who receive HMAs compared with those who receive TTR,but there is no significant difference in 2-year OS.
作者
郭怀鹏
康蕾
刘聪
周柰岑
刘英
崔栋
刘利
GUO Huaipeng;KANG Lei;LIU Cong;ZHOU Naicen;LIU Ying;CUI Dong;LIU Li(Second Affiliated Hospital of Air Force Medical University,Xian,710083,China)
出处
《临床血液学杂志》
CAS
2021年第5期347-352,共6页
Journal of Clinical Hematology
