【摘要】 目的初步评价环孢素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。方法于2000年10月至2005年10月取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血液六科的32例骨髓增生异常综合征患者,随机分为两组,分别接受了环孢素A(A组,n=14)或环孢素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<0.05]。A组红系显效3例;血小板显效2例,有效1例;中性粒细胞显效2例,有效1例。B组红系显效11例,有效1例;血小板显效5例,有效2例;中性粒细胞显效3例,有效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,二者疗效比较差异有统计学意义(P<0.05)。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素A好,出现肝肾功能异常是可逆性的。更多还原

【Abstract】 Objective To explore the outcome and side-effects in patients with myelodysplastic syndromes(MDS)treated with cyclosporine A without or with thalidomide.Methods To compare the outcome and side-effects in 32 patients with MDS from October 2000 to October 2005,treated with cyclosporine A(CSA)as single agents(n=14,group A)or CSA combined with thalidomide(n=18,group B).Results Three patients of group A(21.4%)and twelve of group B(66.7%,P<0.05)achieved hematologic improvement.Three patients achieved a HI-E(three major),three patients HI-P(two major,one minor)and three patients HI-N(two major,one minor)within group A.Twelve patients achieved a HI-E(eleven major,one minor),seven patients HI-P(five major,two minor)and six patients HI-N(three major,three minor)within group B.Two patients(2/11 cases,18.2%)became transfusion independence within group A,while nine patients(9/14 cases,64.3%)became transfusion independence within group B.There was statistic difference between two groups(P<0.05).Nine patients emerged hepatic lesion(three in group A(21.4%),six in group B(33.3%),P=0.457.Three patients emerged nephrotoxicity(one in group A(7.1%),two in group B(11.1%,P=0.702).These patients all made a recovery by treatment.Conclusion CSA combined while thalidomide is ahighly effective and relatively well-tolerated treatment for patients with MDS.更多还原