氨磷汀在骨髓增生异常综合征治疗中应用探究.docVIP

氨磷汀在骨髓增生异常综合征治疗中应用探究 　【摘要】 本研究探讨氨磷汀(amifostine, AMF)对骨髓增生异常综合征(MDS)患者的疗效及副作用。采用单用AMF或联合红细胞生成素(rhEPO)治疗12例MDS患者，其中8位高龄患者采用AMF联合rhEPO治疗，4 例单用AMF治疗。治疗方案为AMF 0.4 g静脉滴注，5天为1疗程，休息2天，连续3疗程为1个治疗周期；rhEPO 6 000 U，皮下注射，1周3次。结果显示：12例MDS患者的血液学指标均有改善，显效11例（91.7%），微效1例（8.3%）， 其中血红蛋白有效率为100%， 白细胞有效率为75%， 血小板有效率为58.3%。2例长期依靠输血的患者在氨磷汀治疗后输血间隔逐渐延长，输血量明显减少。AMF的副作用主要表现为胃肠道反应，但所有患者均可耐受。结论：氨磷汀是骨髓增生异常综合征治疗中一种较有潜力的药物，对同时伴有多器官基础疾病的高龄患者更是一种安全、有效的药物，其疗效随维持时间的延长而显著提高。 【关键词】 氨磷汀 红细胞生成素 骨髓增生异常综合征 Amifostine Used in the Treatment of Patients with Myelodysplastic Syndrome Abstract The study was aimed to investigate the curative effects and adverse effects of amifostine in the treatment of patients with myelodysplastic syndrome（MDS）. Amifostine(AMF) was used alone（4/12）or combined with recombinant human erythropoietin (rhEPO)（8/12）in 12 MDS patients. The therapeutic regimen was adopted with AMF 0.4 g/day for 5 days, then took a break of 2 days and then went on for 3 weeks consecutively, that was reputed as one treatment cycle. rhEPO 6 000 U was used for 3 days per week. The results showed that 12 patients all attained hematological improvement in peripheral blood. 11 cases showed major effective response rate (91.7%), while 1 case showed minor response rate (8.3%). The effective response rate of hemoglobin, leukocytes and platelets was 100%, 75% and 58.3% respectively. The intervals of red cell transfusions (RCT) in 2 cases living on red cell transfusion before AMF treatment were prolonged after AMF treatments, and the amount of each RCT was decreased obviously. The side effect was usually discomfort of digestive system, but all patients can endure. In conclusion, Amifostine is a potential drug in the treatment of MDS patients with safety especially to those elder patients who often suffered from other multiple organ disfunctions, and the curative effect will be improved by more treatment cycles. Key words amifostine; rhEPO; myelodysplastic syndrome 骨髓增生异常综合征是一种造血干细胞异常克隆性疾病，多发于老年人，其主要特征是骨髓无效造血