急性髓性白血病患者接受中、高剂量阿糖胞苷门诊巩固化疗的疗效。沙特阿拉伯达曼法哈德国王专科医院的经验

Al-Anazi Khalid Ahmed, NJ Alsaeed, S. Kanfer, P. Kalogiannidis, W. Alenazi, Z. Alshammasi, O. Abduljalil, E. Mutahar, FH Albeladi, I. Apostolidis, M. Darweesh, N. Almokhtar, M. Abdulbaqi, O. Albanyan, Z. Alshaibani, H. Raslan, A. Aldayel, R. Alrabeh, W. Dridi, S. Alharbi, Z. Alsomali, M. Albatran, A. Alshami, A. Ayyad, K. Alhowaish, BA Alblowe, F. Nightingale, A. Alshehabat, F. Abu Rahma, H. Alhashmi
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引用次数: 0

摘要

背景:传统上,急性髓性白血病(AML)成人患者在强化巩固化疗期间一直住院治疗,直到血细胞计数恢复,以避免并发症。最近,有一种趋势是将接受强化化疗的急性髓细胞白血病患者从住院治疗转为门诊治疗,以降低治疗成本并节省床位。方法和材料:对沙特阿拉伯达曼法哈德国王专科医院 2016 年 8 月 1 日至 2023 年 12 月 31 日期间接受阿糖胞苷巩固化疗的急性髓细胞白血病患者进行回顾性研究。研究结果在7年零4个月的时间里,62名患者在门诊接受了共计127个周期的强化巩固化疗。确诊时:12 名患者患有髓外疾病,17 名患者有不良细胞遗传学异常。在127个化疗周期中,38例患者出现发热性中性粒细胞减少症,46例患者需要住院治疗。在62.2%的巩固治疗周期中没有出现并发症,也没有因强化巩固治疗导致早期死亡的报道。在研究的62名患者中,有36名患者接受了各种形式的造血干细胞移植。24名患者病情复发,整组患者的5年复发率为42%。整个研究患者、移植患者和非移植患者的5年无白血病生存率分别为43%、38%和50%:分别为 43%、38% 和 50%。全部研究患者、移植患者和非移植患者的 5 年总生存率分别为:44%、34% 和 65%:分别为 44%、34% 和 65%。随访结束时,37 名患者(59.68%)存活,24 名患者(38.71%)死亡,1 名患者(1.61%)因转院而去向不明。结论在门诊对急性髓细胞白血病患者进行强化巩固化疗是安全、可行和经济的。感染性并发症的发生率相对较低。没有出现因强化巩固治疗导致的早期治疗相关死亡率。门诊进行强化巩固治疗可节省床位、降低医院成本,其短期和长期疗效与住院进行巩固治疗相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Outcome of Outpatient Intermediate and High Dose Cytarabine Consolidation Chemotherapy in Patients with Acute Myeloid Leukemia. The Experience of King Fahad Specialist Hospital in Dammam, Saudi Arabia
Background: Adult patients with Acute Myeloid Leukemia (AML) have traditionally been hospitalized for the duration of intensive consolidation chemotherapy until blood count recovery to avoid complications. Recently, there has been a trend to shift the care of AML patients treated with intensive chemotherapy from inpatient to outpatient settings to reduce treatment costs and save beds. Methods and materials: A retrospective study of AML patients who received cytarabine consolidation chemotherapy between the 1st of August 2016 and the 31st of December 2023 at King Fahad Specialist Hospital in Dammam, Saudi Arabia was performed. Results: Over a period of 7 years and 4 months, 62 patients received a total of 127 cycles of intensive consolidation chemotherapy at outpatient setting. At diagnosis: 12 patients had extramedullary disease, and 17 patients had adverse cytogenetic abnormalities. Following the 127 cycles of chemotherapy, 38 episodes of febrile neutropenia were encountered, and 46 hospital admissions were required. No complications were encountered following 62.2% of the cycles of consolidation therapy and no early mortality due to intensive consolidation therapy was reported. Out of 62 patients studied, 36 patients underwent various forms of hematopoietic stem cell transplantation. Disease relapses were encountered in 24 patients and the 5-year incidence of relapse for the entire group of patients was 42%. The 5-year leukemia-free survival for the: entire study patients, transplanted patients, and non-transplanted patients were: 43%, 38%, and 50% respectively. The 5-year overall survival for the: entire study patients, transplanted patients, and non-transplanted patients were: 44%, 34%, and 65% respectively. At the end of follow-up: 37 patients (59.68%) were alive, 24 patients (38.71%) were dead, and the fate of 1 patient (1.61%) was unknown as the patient moved to another hospital. Conclusion: Administration of intensive consolidation chemotherapy for patients with AML at outpatient setting is safe, feasible, and cost-effective. The incidence of infectious complications was relatively low. No early treatment-related mortality due to intensive consolidation therapy was encountered. Outpatient administration of intensive consolidation therapy can save beds, reduce hospital costs, and is associated with short-term and long-term outcomes that are comparable to inpatient administration of consolidation therapy.
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