Objective: To investigate the efficacy and safety of dexithabine (DAC) combined with HAAG regimen [harringtonine (HHT), cytarabine (Ara-C), aclarubicin (Acla) and recombinant human granulocyte colony stimulating factor (G-CSF)] in the treatment of acute myeloid leukemia (AML). Methods: The clinical data of 89 AML patients in People's Hospital Affiliated to Shandong First Medical University from January 2019 to January 2021 were retrospectively analyzed. The patients were divided into observation group (n=48) and control group (n=41) according to the treatment plan. The observation group included 25 males and 23 females, aged (44.4±9.3) years old, and was treated with DAC combined with HAAG. The control group included 24 males and 17 females, aged (42.2±10.1) years old, and was treated with DAC regimen. After 3 cycles of treatment, the treatment efficacy of the two groups was judged, including complete remission, partial remission and no remission. The level of serum P-glycoprotein (P-gp) in the two groups was detected by direct immunofluorescence-labeled monoclonal antibody flow cytometry. The enzyme-linked immunosorbent assay was used to detect the level of soluble urokinase-type plasminogen activator receptor (suPAR). Meanwhile, the incidence of adverse reactions such as digestive tract reaction, liver and kidney dysfunction, hemorrhage and infection during treatment were recorded. Results: After 3 cycles of treatment, the observation group had complete remission, partial remission and no remission in 10 cases, 21 cases and 17 cases, respectively, and the control group had 3 cases, 11 cases and 27 cases, respectively. The overall efficacy of the observation group was better than that of the control group (Z=-2.919, P=0.004). The levels of serum P-gp and suPAR in the observation group were (5.2±1.8) % and (464.4±103.4) ng/L, respectively, which were significantly lower than those in the control group [(8.8±1.9) % and (660.6±110.4) ng/L, respectively] (both P<0.05). During the treatment, the incidence of digestive tract reaction, liver and kidney dysfunction, hemorrhage and infection in the observation group was 29.2% (14/48), 22.9% (11/48), 16.7% (8/48) and 33.3% (16/48), respectively, while in the control group was 26.8% (11/41), 21.9% (9/41), 14.6% (6/41) and 24.4% (10/41), respectively, with no statistically significant difference (all P>0.05). Conclusions: The overall efficacy of DAC combined with HAAG in the treatment of AML is better than that of DAC alone. Moreover, the incidence of adverse reactions in DAC combined with HAAG is similar to that of DAC alone, with a high safety profile.
目的： 探讨地西他滨（DAC）联合HAAG方案［三尖杉酯碱（HHT）、阿糖胞苷（Ara-C）、阿柔比星（Acla）和重组人粒细胞集落刺激因子（G-CSF）］治疗复发急性髓系白血病（AML）的效果及安全性。 方法： 回顾性分析2019年1月至2021年1月山东第一医科大学附属人民医院89例复发AML患者的临床资料，根据治疗方案分为观察组（n=48）和对照组（n=41）。观察组包括男25例，女23例，年龄（44.4±9.3）岁，给予DAC联合HAAG方案治疗。对照组包括男24例，女17例，年龄（42.2±10.1）岁，给予DAC方案治疗。治疗3个周期后判断两组患者治疗效果，包括完全缓解、部分缓解及未缓解。采用直接免疫荧光标记单抗流式细胞仪检测两组患者血清P-糖蛋白（P-gp）水平，采用酶联免疫吸附试验检测可溶性尿激酶型纤溶酶原激活剂受体（suPAR）水平。记录两组患者治疗期间消化道反应、肝肾功能异常、出血、感染等不良反应发生率。 结果： 治疗3个周期后，观察组完全缓解、部分缓解及未缓解分别为10例、21例、17例，对照组分别为3例、11例、27例，观察组患者的总体疗效优于对照组（Z=-2.919，P=0.004）。观察组治疗3个周期后血清P-gp和suPAR水平分别为（5.2±1.8）%和（464.4±103.4）ng/L，明显低于对照组的（8.8±1.9）%和（660.6±110.4）ng/L（均P<0.05）。观察组治疗期间消化道反应、肝肾功能异常、出血、感染发生率分别为29.2%（14/48）、22.9%（11/48）、16.7%（8/48）、33.3%（16/48），对照组分别为26.8%（11/41）、21.9%（9/41）、14.6%（6/41）、24.4%（10/41），差异均无统计学意义（均P>0.05）。 结论： DAC联合HAAG方案治疗AML的总体疗效优于单独应用DAC，其不良反应发生率与单独应用DAC相近，安全性较好。.