[Clinical Comparation of Two Kinds of Chemotherapy Regimens in the Treatment of Patients with MDS-RAEB/AML-MRC]

To investigate the influence of conventional CAG regimen and decitabine + decreased dose CAG (D+dCAG) regimen on the clinical efficacy and safety of patients with MDS-RAEB/AML-MRC.The clinical data of 67 patients with MDS-RAEB/AML-MRC hospitalized in our hospital from March 2012 to July 2017 were analyzed retrospectively. According to chemotherapecctic regimens, 76 patients were divided into 2 groups: 37 patients treated with conventional CAG regimen were enrolled in control group, 30 patients treated with decitabine + decreased dose CAG regimen were enrolled in D+dCAG group. The complete remission (CR) rate, overall remission rate (ORR), OS and PFS time and incidence of adverse reactions in 2 groups were compared.The CR in D+dCAG group was significantly higher than that in control group (P＜0.05). ORR was not significanly different between 2 groups (P＞0.05). There was no significant difference in the cumulative OS rate between 2 groups (P＞0.05). There was no significant difference in the cumulative OS rate and PFS rate in nonimplantation between 2 groups (P＞0.05). The incidence of adverse reactions of hematological system, pulmonary infection, skin and soft tissue infection, agranulocytosic fever and mycotic infection was not significanly different between 2 groups (P＞0.05). The duration of granulocyte deficiency and platelet count less than 20×10Compared with conventional CAG regimen, decitabine + decreased dose CAG regimen in the treatment of patients with MDS-RAEB/AML-MRC can efficiently improve the remission effects and showed the well overall safety, but can not increase the survival rate.不同化疗方案治疗MDS-RAEB/AML-MRC临床对比研究.探讨常规CAG方案与地西他滨+减量CAG方案对骨髓增生异常综合征伴原始细胞增多（MDS-RAEB）/急性髓系白血病伴骨髓增生异常相关改变（AML-MRC）患者疗效及安全性的影响.回顾性分析于2012年3月-2017年7月本院收治的67例MDS-RAEB/ AML-MRC患者的临床资料。67例中采用常规CAG方案治疗37例设为对照组，采用地西他滨+减量CAG方案治疗30例设为D+dCAG组，比较2组患者的完全缓解（CR）率、总缓解率（ORR）、总生存时间（OS）、无进展生存时间（PFS）及不良反应的发生率.D+dCAG组CR率显著高于对照组（P＜0.05）；2组ORR比较差异无显著性（P＞0.05）；2组累积OS率比较差异无显著性（P＞0.05）；2组非移植的累积OS率和PFS率比较差异无显著性（P＞0.05）；2组血液系统不良反应、肺部感染、皮肤软组织感染、粒细胞缺乏期发热及真菌感染发生率比较差异无显著性（P＞0.05）；2组粒细胞缺乏持续时间和血小板计数小于20×10相较于常规CAG方案，地西他滨+减量CAG方案治疗MDS-RAEB/AML-MRC在改善疾病缓解效果方面具有优势，总体安全性良好，但仍未提高患者的生存率.