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1、http://www.paper.edu.cn环孢菌素A单独或联合沙利度胺治疗骨髓增生异常综合征徐泽锋李睿张莉郝玉书肖志坚作者单位:300020天津,中国医学科学院中国协和医科大学血液学研究所血液病医院;实验血液学国家重点实验室基金资助:天津市自然科学基金(05YFJMJC02000),高等学校博士学科点专项科研基金(20050023033)通信作者:肖志坚通信地址:300020天津市南京路288号中国医学科学院血液学研究所FAX:022-27306542TEL:022-27219070Email:zjx
2、iao@hotmail.com1http://www.paper.edu.cn【摘要】目的初步评价环孢菌素A单独应用或联合沙利度胺治疗骨髓增生异常综合征的疗效与不良反应。方法32例骨髓增生异常综合征患者分为两组,分别接受环孢菌素A(A组,n=14)或环孢菌素A联合沙利度胺(B组,n=18)治疗,比较两组的疗效和不良反应。结果共15例患者取得血液学进步[A组3例(21.4%),B组12例(66.7%),P=0.011]。A组红系显效3例;血小板显效2例,轻效1例;中性粒细胞显效2例,轻效1例;B组红系显效1
3、1例,轻效1例;血小板显效5例,轻效2例;中性粒细胞显效3例,轻效3例。A组11例依赖输血的患者中2例(18.2%)脱离输血,B组14例依赖输血的患者中9例(64.3%)脱离输血,二者疗效比较有统计学意义(P=0.021)。共9例患者出现肝功能异常[A组3例(21.4%),B组6例(33.3%),P=0.457],3例出现肾功能异常[A组1例(7.1%),B组2例(11.1%),P=0.702],经停药或治疗后均好转。结论联合环孢菌素A和沙利度胺治疗骨髓增生异常综合征疗效较单用环孢菌素A好,出现肝肾功能异
4、常是可逆性的。【关键词】骨髓增生异常综合征;环孢菌素A;沙利度胺;疗效;不良反应CyclosporineAwithoutorwiththalidomideforthetreatmentofpatientswithmyelodysplasticsyndromesXUZe-feng,LIRui,ZHANGLi,HAOYu-shu,XIAOZhi-jian.InstituteofHematologyandBloodDiseaseHospital,StateKeyLaboratoryofExperimentHem
5、atology,CAMS&PUMC,Tianjin300020,ChinaCorrespondingauthor:XIAOZhi-jian【Abstract】ObjectiveToexploretheoutcomeandside-effectsinpatientswithmyelodysplasticsymdromes(MDS)treatedwithcyclosporineAwithoutorwiththalidomide.MethodsTocomparetheoutcomeandside-effects
6、in30patientswithMDS,treatedwithcyclosporineA(CSA)assingleagents(n=14,groupA)orCSAcombinedwiththalidomide(n=18,groupB).ResultThreepatientsofgroupA(21.4%)andtwelveofgroupB(66.7%,P=0.011)achievedhematologicimprovement.ThreepatientsachievedaHI-E(threemajor),t
7、hreepatientsHI-P(twomajor,oneminor)andthreepatientsHI-N(twomajor,oneminor)withinthegroupA.TwelvepatientsachievedaHI-E(elevenmajor,oneminor),sevenpatientsHI-P(fivemajor,twominor)andsixpatientsHI-N(threemajor,threeminor)withingroupB.Twopatients(2/11cases,18
8、.2%)becametransfusionindependencewithingroupA,ninepatients(9/14cases,64.3%)becametransfusionindependencewithingroupB.Therewasstatisticdifferencebetweentwogroups(P=0.021).Ninepatientsemergedhepaticlesion(threeingroup