摘要
目的探讨维奈克拉治疗急性髓系白血病(AML)患者的疗效及对T淋巴细胞亚群、预后的影响。方法依据随机数字表法将82例AML患者分为对照组(38例)和试验组(44例),对照组和试验组各脱落3例和5例,最终对照组和试验组各纳入35例和39例进行研究。对照组给予注射用阿扎胞苷皮下注射治疗,试验组在对照组的基础上给予维奈克拉片口服治疗,两组均持续治疗2个疗程后进行为期14个月的随访。比较两组患者的疗效、血液指标[骨髓原始细胞非红系细胞计数(NEC)、血小板计数(PLT)、血红蛋白(Hb)]、T淋巴细胞亚群、肿瘤标志物[血管内皮生长因子(VEGF)、肿瘤特异性生长因子(TSGF)、乳酸脱氢酶(LDH)、环氧化酶-2(COX-2)]、不良反应发生情况和随访14个月的预后情况。结果治疗2个疗程后,试验组患者的总缓解率高于对照组,差异有统计学意义(P﹤0.05)。治疗后,两组患者PLT、Hb均较治疗前升高,NEC均较治疗前降低,且试验组患者PLT、Hb均高于对照组,NEC低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)水平均较治疗前降低,且试验组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者VEGF、TSGF、LDH、COX-2水平均较治疗前降低,且试验组患者VEGF、TSGF、LDH、COX-2水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗期间,试验组患者骨髓抑制、胃肠道不适发生率均低于对照组,差异均有统计学意义(P﹤0.05)。两组生存情况比较,差异有统计学意义(P﹤0.05)。结论维奈克拉能够提高AML患者疗效,减轻不良反应,并可促进患者预后改善,考虑可能与该药能够调节患者机体血液指标、T淋巴细胞亚群及肿瘤标志物水平有关。
Objective To investigate the efficacy of venetoclax in the treatment of patients with acute myeloid leukemia(AML)and its influence on T lymphocyte subsets and prognosis.Method According to the random number table method,82 AML patients were divided into the control group(38 cases)and the experimental group(44 cases).The control group and the experimental group dropped out 3 cases and 5 cases,respectively.Finally,35 cases and 39 cases were included in the control group and the experimental group respectively for the study.The control group was treated with subcutaneous injection of azacitidine for injection,and the experimental group was treated with oral venetoclax tablets on the basis of the control group.Both groups were treated for 2 courses and followed up for 14 months.The efficacy,blood indexes[non-erythroid cell(NEC),platelet count(PLT),hemoglobin(Hb)],T lymphocyte subsets,tumor markers[vascular endothelial growth factor(VEGF),tumor specific growth factor(TSGF),lactate dehydrogenase(LDH),cyclooxygenase-2(COX-2)],the incidence of adverse reactions,and the prognosis of 14 months follow-up were compared between the two groups.Result After 2 courses of treatment,the total response rate of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,PLT and Hb in the two groups were higher than those before treatment,and NEC were lower than those before treatment,and PLT and Hb in the experimental group were higher than those in the control group,and NEC was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were higher than those before treatment,and the levels of CD8^(+)were lower than those before treatment,and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the experimental group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of VEGF,TSGF,LDH and COX-2 in the two groups were lower than those before treatment,and the levels of VEGF,TSGF,LDH and COX-2 in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).During the treatment,the incidences of bone marrow suppression and gastrointestinal discomfort in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was statistically significant difference in survival between the two groups(P<0.05).Conclusion Venetoclax can improve the efficacy of patients with AML,reduce adverse reactions,and promote the improvement of the prognosis,which may be related to the drug’s ability to regulate the levels of blood indexes,T lymphocyte subsets and tumor markers.
作者
李楠
许惠丽
刘冰
周雪芳
LI Nan;XU Huili;LIU Bing;ZHOU Xuefang(Ward 2,Department of Hematology Lymphoma,Pingdingshan First People’s Hospital,Pingdingshan 467036,He’nan,China)
出处
《癌症进展》
2025年第13期1573-1577,共5页
Oncology Progress
