沙利度胺联合CAG方案治疗难治性贫血（MDS）的临床研究

【摘要】 目的 ：探讨沙利度胺联合CAG方案治疗高危MDS的临床疗效及不良反应。方法：37例MDS患者随机分为治疗组：LD-Ara-C 10mg-/㎡,每12h1次,皮下注射,第1-14天,阿克拉霉素AcR5-7 /㎡.d,1-8天。治疗组:CAG方案加沙利度胺, 沙利度胺起始量200mg/d,每2周增加50-200mg, 至患者不能耐受,或最高剂量不超过每日400mg, 维持该剂量半年。结果:治疗组骨髓完全缓解(CR)9例（48﹪）,部分缓解(PR )6例（30﹪），血液学改善(HI)3例,无效1例,总有效率90%,明显优于对照组总有效率78%（P＜0.05）。且治疗后患者血清血管内皮细胞生长因子（VEGF）水平明显下降,与对照组比较差异有统计学意义（P＜0.01）,副作用均可耐受。结论: 沙利度胺联合CAG方案治疗高危MDS具有副作用少,耐受性好,给药方便,疗效明显等优点,值得临床深入研究和推广应用 。

【 关键词 】MDS CAG方案 沙利度胺 血管内皮细胞生长因子

［中国文分类号］ ［文献标识码］ ［文章编号］

The clinical research of thalidomide incorporation with CAG

in treatment of high risk MDS

GE XIANG HUE

( Linyi City People^, s Hospital,Linyi,China 276002)

Abstract objective：TO study the curative effect and side effect of

thalidomide incorporation with CAG in treatment of high risk MDS.Method：37 MDS patients were randomly divided into CAG group，CAG plus thalidomide respectively the beginning dose of thalidomide was 200mg/d increased 50 to 200mg every 2 weeks till the intolerant dose or below 400mg/d maintained for half a year.Results：The experimental 9 cases had got complete remission CR 48% ，6 cases partial remission PR30% ，3 cases improved ，and 6 cases ineffective .Totaleffective rate was 90% ，significantly higher than that in controlgroup withtotal efficacy rate 78%( p＜ 0.05) ，the level of vascular en-dothelial growth factor VEGF in treatment group was significantly lower than that of control group( p＜ 0.01).while the side effects were tolerable Conclusion：Thalidomide incorporation with CAG applied in MDS has

merits such as less side effects，good tolerance convenient administration and significant curative effect，it would be valuable to clinical research and widespread popularization.

Key words MDS CAG Thalidomide VEGF

骨髓增生异常综合征（MDS）高危型是指转化为白血病概率较高的MDS亚型,包括难治

性贫血伴原始细胞增多症（RAEB）,转化中的难治性贫血伴原始细胞增多型（RAEB-T）,临

临沂市人民医院 （临沂 山东 276002）

床治疗难度大,强烈化疗风险高,且缓解率低。 沙利度胺（商品名反应停）,是一种血管生成抑制剂,也是一种免疫调节剂,文献报道对MDS有抗肿瘤活性。关于沙利度胺联合CAG方案治疗高危MDS的报道尚不多见,为此,我们采用沙利度胺联合CAG方案治疗高危MDS37例患者,以期提高临床疗效,现将结果报道如下。