阿扎胞苷治疗骨髓增生异常综合征、慢性髓单细胞白血病2型和急性髓系白血病的细胞遗传学研究

Q4 Medicine
D. Nikolova, A. Yordanov, A. Radinov
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引用次数: 0

摘要

摘要简介:阿扎胞苷是一种可用于治疗老年骨髓增生异常综合征(MDS)或急性髓系白血病(AML)患者的低甲基化药物。在现实生活中,它也被用作慢性粒单核细胞白血病(CMML)的适当治疗。由于AML和CMML的治疗不能治愈,而且异基因干细胞移植(allo-SCT)传统上仍然是唯一的选择,因此已经报道了低甲基化药物的显著临床益处。根据现有数据,16%接受阿扎胞苷治疗的MDS患者的血细胞计数和骨髓形态完全或部分正常,而三分之二需要输血的患者不再需要输血。然而,它也可能对严重肝损伤和广泛肝肿瘤患者具有肝毒性。目的:根据患者的一般情况、血液计数参数、毒性(一般和血液学)以及细胞遗传学异常的存在,总结阿扎胞苷治疗的效果。材料与方法:27例患者接受阿扎胞苷治疗,其中MDS 15例,CMML 9例,AML 3例。对血细胞计数水平和毒性进行了为期12个月的随访。结果:22.2%的不同血液学诊断的患者(27例中有6例)的DNA出现遗传畸变。他们都表现出疾病进展迅速和致命的结果,其中四人还出现了血液学毒性。其余77.8%没有细胞遗传学发现。在所有队列中,19.05%的患者在治疗过程中出现毒性,38%的患者白细胞水平下降,14.3%的患者血小板水平下降,18.2%的患者血红蛋白水平下降。红细胞水平没有受到治疗的实质性影响。在治疗的第0个月至第6个月期间,大多数患者的红细胞、血小板和血红蛋白水平保持稳定,没有显著变化。结论:我们的研究结果表明,阿扎胞苷治疗我们患者的主要缺点是进行性白细胞减少症(10/27例,占37%)和毒性(8/27例,占29.6%)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Azacitidine Treatment in Patients with Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia Type 2 and Acute Myeloid Leukemia According to their Cytogenetic Findings
Abstract Introduction: Azacitidine is one of the hypomethylating agents available for the treatment of elderly patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). It is also used as an appropriate treatment of chronic myelomonocytic leukemia (CMML) in the real life setting. As treatment of AML and CMML is not curative, and allogeneic stem cell transplantation (allo-SCT) remains traditionally the only option, significant clinical benefits by hypomethylating agents have been reported. According to the available data, 16% of subjects with MDS who received azacitidine had a complete or partial normalization of blood cell counts and bone marrow morphology, while two-thirds of patients who required blood transfusions no longer needed them. Nevertheless, it can also be hepatotoxic in patients with severe liver impairment and extensive liver tumors. Aim: to summarize the effect of azacitidine treatment in patients in the light of their general condition, blood count parameters, toxicity (general and hematologic), as well as the presence of cytogenetic aberrations. Materials and Methods: Twenty-seven patients of which 15 patients with MDS, 9 patients with CMML and 3 patients with AML received azacitidine treatment. The blood count levels and toxicity were followed for a period of twelve months. Results: 22.2% of our patients (6 of 27) of different hematologic diagnoses showed genetic aberrations in their DNA. All they showed quick disease progression and fatal outcome, four of them also developed hematologic toxicity. The remaining 77.8% had no cytogenetic findings. Of all the cohort, 19.05% developed toxicity during the course of the treatment, 38% – decreased leucocyte levels, 14.3% – decreased thrombocyte levels and 18.2% – decreased hemoglobin level. The erythrocyte levels were not substantially influenced by the treatment. The majority of the patients sustained stable levels of red blood cells, as well as of platelets and hemoglobin without remarkable changes between month 0 and month 6 of the treatment. Conclusion: Our results showed, that the main disadvantage of azacitidine treatment in our patients were progressive leucopenia (in 10/27 patients or 37% of cases) and toxicity (8/27 or 29.6% of cases).
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来源期刊
Acta Medica Bulgarica
Acta Medica Bulgarica Medicine-Medicine (all)
CiteScore
0.30
自引率
0.00%
发文量
33
审稿时长
25 weeks
期刊介绍: About 30 years ago - in 1973, on the initiative of the Publishing House „Medicine and Physical Culture", namely its former director Mr. Traian Ivanov, the Ministry of Health set up and accepted to subsidize a new medical magazine that was to be published only in the English language and had to reflect the status and the achievements of the Bulgarian medical science. Thus the language barrier was overcome and stable relations were established with the international medical society, large libraries, and university centers. The famous internationally known scientist professor Assen A. Hadjiolov was elected edition-in-chief by the first editorial staff and the magazine was named Acta Medica Bulgarica.
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