MA诱导方案与DA诱导方案对老年急性髓系白血病患者血清炎症因子及复发率的影响

目的:探讨米托蒽醌联合阿糖胞苷(MA方案)与柔红霉素联合阿糖胞苷(DA方案)对老年急性髓系白血病(AML)患者血清炎症因子及复发率的影响。方法:选取2015年1月~2018年1月期间深圳市人民医院收治的老年AML患者129例,根据治疗方案的不同将患者分为DA组(n=64,DA方案治疗)和MA组(n=65,MA方案治疗),比较两组患者疗效、炎症因子、不良反应及复发情况。结果:MA组治疗后的临床总有效率高于DA组(P<0.05)。两组患者治疗后血清干扰素γ诱导蛋白-10(IP-10)、巨噬细胞炎症蛋白-1α(MIP-1α)及可溶性细胞间黏附分子1(sICAM-1)水平均降低,且MA组低于DA组(P<0.05)。MA组完全缓解患者中累计复发率低于DA组(P<0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:与DA诱导方案相比,MA诱导方案治疗老年AML患者,可有效改善炎症因子水平,减少复发,且用药安全性较好。

The Effect of MA Induction and DA Induction on Inflammatory Factors and Recurrence Rate in Elderly Patients with Acute Myeloid Leukemia

Objective: To investigate the effect of mitoxantrone combined with cytarabine(MA) and daunorubicin combined with cytarabine(DA) on inflammatory factors and recurrence rate in elderly patients with acute myeloid leukemia(AML). Methods: 129 elderly AML patients who were admitted to Shenzhen People’s Hospital from January 2015 to January 2018 were selected, the patients were divided into DA group(n=64, DA scheme treatment) and MA group(n=65, MA scheme treatment) according to different treatment schemes, the curative effect, inflammatory factors, adverse reactions and recurrence rate of the two groups were compared. Results: The total clinical effective rate of MA group was higher than that of DA group after treatment(P<0.05). The levels of IFN-γ-inducible protein-10(IP-10), macrophage inflammatory protein-1α(MIP-1α) and soluble intercellular adhesion molecule-1(sICAM-1) were all decreased of the two groups after treatment, and the level of MA group was lower than that of DA group(P<0.05). The cumulative recurrence rate in patients with complete remission of group MA was lower than that of group DA(P<0.05). There was no difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Compared with DA induction program, MA induction program can effectively improve the level of inflammatory factors and reduce the recurrence of elderly AML patients, and has better drug safety.