Analysis Of The Clinical Efficacy And Safety Of Azacitidine Consolidation And Maintenance Treatment Of Acute Myeloid

Objective:Retrospective analysis of the clinical efficacy and safety observations of azacitidine drugs in the consolidation and maintenance treatment of adult patients with acute myeloid leukemia.Methods:Collected and analyzed 40 cases.From December 2016 to December 2021,patients who were admitted to the Department of Hematology at the First Affiliated Hospital of Kunming Medical University received azacitidine regimen for consolidation and maintenance treatment.Data on adult patients with acute myeloid leukemia that can be evaluated for efficacy.Received 16 patients who use the azacitidine consolidation and maintenance treatment,and 24 patients received traditional regimen consolidation and maintenance.Among them,due to the different treatment phases,it can be divided into consolidation phase and maintenance phase.The consolidation phase is divided into azacitidine consolidation treatment group(n=10 cases)and traditional consolidation treatment group(n=13).Among them,the AZA consolidation treatment group was treated with AZA monotherapy or AZA+CAG combined regimen,and the traditional consolidation treatment group was treated with cytarabine or DA,IA,and MA regimens.The course of consolidation treatment was 4 courses.The maintenance phase is divided into azacitidine maintenance treatment group(n=6)and traditional regimen maintenance treatment group(n=11).Among them,the AZA maintenance treatment group adopts AZA single-agent maintenance treatment,and the traditional maintenance group adopts CAG and BSC.Analyze,observe and evaluate the efficacy(RFS)of patients after treatment in the consolidation phase and the efficacy(OS)of all patients receiving consolidation and maintenance treatment,influencing factors,and the incidence of adverse reactions in patients,etc.All patients were statistically processed using SPSS 21.00 statistical software,P<0.05 was statistically significant.Results:1.OS:During the entire consolidation and maintenance treatment,the median OS of the azacitidine group and the traditional consolidation and maintenance group were 19 months and 15.5 months,respectively.Draw the Kaplan-Meier curve to evaluate the 1-year OS rates of patients were 84%and 65%,and the 2-year OS rates were 72%and 41%,respectively.Into Log-rank test comparison between groups,Log Rank P=0.044<0.05,the difference was statistically significant.It shows that the OS rate of patients in the AZA group is higher than that of the traditional consolidation and maintenance group.2.RFS:In the consolidation treatment phase,the median RFS of the AZA group and the traditional consolidation treatment group were 9 months and 8 months,respectively.The Kaplan-Meier curve was drawn to evaluate the 1-year RFS rates of patients as 50%and 35%,respectively.There was no statistically significant difference between the two groups(P>0.05).However,after entering the maintenance phase,follow-up found that none of the patients treated with the AZA regimen had recurrence or death,and 9 patients who used the traditional regimen maintenance treatment relapsed and all died of disease or related complications.It shows that the AZA program may have a better effect in the maintenance phase.3.Adverse reactions:①Observe the absolute neutrophil count and platelet recovery time of the AZA group and the control group.Chi-square test P<0.05 for both groups of data,the difference is statistically significant.It shows that the recovery of NEC and PLT in the AZA group is earlier than that in the traditional group.②The incidences of nausea and vomiting in the two groups were 33.3%and 59.8%,respectively.Chi-square test P=0.001<0.05,the results were statistically significant.It shows that the incidence of nausea and vomiting is less in the AZA group.③Observe the incidence of infection in the two groups of patients,compared with the incidence of liver and kidney function damage,the difference is not statistically significant(P>0.05).Conclusions:1.The 1-year recurrence-free survival rate of middle-aged and elderly patients with AML using azacitidine consolidation treatment showed a trend that was higher than that of the traditional consolidation treatment group.2.Consolidation therapy with azacitidine can improve the relapse-free survival of middle-aged and elderly AML patients.3.Especially the use of AZA regimen in the maintenance phase may achieve better efficacy.