The Clinical Study Of Lenalidomide In Combination With Chemotherapy In The Treatment Of Leukemia

Objective:Lenalidomide explore classic chemotherapy combined therapy of acute myeloid leukemia with chemotherapy alone classic, the side effects, tolerability, response rate for comparison, in addition carry out bone marrow and serum b FGF, VEGF, such as the detection of contrast to study the relationship between inhibition of angiogenesis factor and leukemia efficacy, lenalidomide monotherapy for the treatment of acute myeloid leukemia exploration, provide a basis for targeted therapy of leukemia.Methods:Select our hospital from October 2013 to October 2014 period novo acute myeloid leukemia(except M3), according to the admission chronological randomly divided into two groups: chemotherapy plus placebo(control group), lenalidomide amine + chemotherapy group(experimental group). Two groups of patients chemotherapy identical, are using DA(3 + 7) solutions. Experimental group was treated with lenalidomide 10 mg daily, placebo-controlled study of daily oral administration of the control group. Two groups of patients before treatment and one week after the end of treatment, bone marrow puncture clinical efficacy analysis, and the use of double-antibody sandwich enzyme-linked immunosorbent assay(ELISA) were detected in serum, such as VEGF and bFGF expression and changes. Separate the healthy control group of 20 patients.Result:The study included 68 patients, according to the admission chronological randomly divided into two groups, in which the control group of 35 patients(M1 1 person, M2 15 people, M4 7 people; M5 9 people; M6 3 people;), the experimental group of 33 Example(M1 2 people, M2 14 people, M4 8 people; M5 6 people; M6 3 people). Group Evaluation: CR19 people, CR rate 54.3%; PR8 people, PR rate 22.9%; CR + PR rate = 77.2%. Evaluate the efficacy of the experimental group: CR22 people, CR rate of 66.7%; PR 7 people, PR rate of 21.2%; CR + PR rate = 87.9%(P <0.05, significant difference). 2. Before treatment, the experimental group and control group, respectively, plasma VEGF levels(312.0 ± 11.07) pg / ml,(275.5 ± 7.568) pg / ml(P> 0.05), significantly higher than the healthy control group(133.0 ± 5.513) pg /ml(P<0.001). Plasma VEGF levels after treatment, respectively(162.6 ± 7.303) pg / ml,(178.3 ± 5.084) pg / ml(P <0.05), still slightly higher than the healthy group(P <0.05). 3. Before treatment, the experimental group and the control group, the plasma levels of bFGF were(33.94 ± 1.527) ng / ml,(30.03 ± 1.413) ng / ml(P> 0.05), significantly higher than the healthy control group(12.01 ± 0.3569) ng /ml(P<0.001). BFGF plasma levels after treatment were(15.41 ± 0.712) ng / ml,(16.43 ± 0.6335) ng / ml(P <0.05), still slightly higher than the healthy group(P1 <0.05, P2<0.05). The linear correlation analysis was found to have a relatively strong positive correlation between plasma VEGF and bFGF and clinical efficacy.Conclusion:Lenalidomide has immunomodulatory and anti-angiogenesis effect, combined with chemotherapy may improve the response rate, without increasing side effects, may inhibit angiogenesis by down-angiogenic factors such as VEGF and bFGF expression of acute leukemia have a supporting role.