实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (3): 283-286.doi: 10.3969/j.issn.1003-9198.2024.03.016

• 临床研究 • 上一篇    下一篇

地西他滨治疗老年骨髓增生异常综合征的疗效以及与TP53基因突变的相关性

张娜, 周婕, 徐锋, 邹文婷, 程丽华, 傅媛媛   

  1. 618000 四川省德阳市,德阳市人民医院血液科
  • 收稿日期:2023-05-15 出版日期:2024-03-20 发布日期:2024-03-26
  • 通讯作者: 周婕,Email:20336922@qq.com
  • 基金资助:
    德阳市科技计划项目(重点研发)(2019SZ050)

Efficacy of different doses of decitabine in the treatment of elderly patients with myelodysplastic syndrome and the relationship with TP53 gene mutation

ZHANG Na, ZHOU Jie, XU Feng, ZOU Wenting, CHENG Lihua, FU Yuanyuan   

  1. Department of Hematology, Deyang People's Hospital, Deyang 618000, China
  • Received:2023-05-15 Online:2024-03-20 Published:2024-03-26
  • Contact: ZHOU Jie, Email:20336922@qq.com

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摘要： 目的 探讨不同剂量地西他滨治疗老年骨髓增生异常综合征(MDS)的疗效及不良反应,以及TP53突变对疗效的影响。 方法 选取本院2020年4月至2022年5月收治的MDS病人共52例,所有病人按照入院先后及适应证分为A组(地西他滨20 mg/d×5 d)28例、B组(地西他滨10 mg/d×10 d)24例,比较2组6周期治疗结束后的临床疗效、不良反应以及地西他滨疗效与TP53基因突变之间的相关性。 结果 A组总有效率为39.3%,B组总有效率为37.5%,2组总有效率差异无统计学意义。2组3～4级中性粒细胞减少、3～4级血小板减少、3～4级贫血发生率差异无统计学意义;2组感染、肝脏受损、发热、胃肠道反应发生率差异无统计学意义。TP53突变型组治疗总有效率为83.3%,TP53野生型组有效率为12.9%,2组差异有统计学意义(P＜0.01)。 结论 地西他滨 20 mg/d×5 d和地西他滨 10 mg/d×10 d治疗方案的总有效率相当,不良反应发生率相当,但TP53突变型病人对地西他滨的反应率明显高于野生型。

关键词: 骨髓增生异常综合征, 地西他滨, TP53突变, 有效率

Abstract: Objective To investigate the efficacy and side effect of different doses of decitabine in the treatment of elderly patients with myelodysplastic syndrome(MDS),and to analyze the correlation of the effect with TP53 gene mutation. Methods A total of 52 patients with MDS admitted in our hospital from April 2020 to May 2022 were enrolled in this study and divided into group A (receiving decitabine 20 mg/d × 5 d, n=28) and group B (receiving decitabine 10 mg/d × 10 d, n=24) according to the indications. The clinical efficacy, toxicity and side effects of the two groups after 6 cycles of treatment were compared, and the correlation of the efficacy with TP53 gene mutation was analyzed. Results The total effective rate was 39.3% in group A,compared with 37.5% in group B(P＞0.05). The incidence rates of grade 3-4 neutropenia, grade 3-4 thrombocytopenia, grade 3-4 anemia, infection, liver damage, fever and gastrointestinal reactions showed no statistical differences between the two groups (P＞0.05). The total effective rate in TP53 mutation group was 83.3%, compared with 12.9% in the wild type group, with significant difference(P<0.01). Conclusions The total effective rate and the incidence of adverse reactions of decitabine 20 mg/d × 5 d and decitabine 10 mg/d ×10 d shows no significant differences. The response rate in patients with TP53 mutation to decitabine is significantly higher than that of patients with wild-type TP53.

Key words: myelodysplastic syndrome, decitabine, TP53 mutation, effective rate

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