| Objective:To explore capecitabine combined with half quantity of CAG regimen therapy in elderly patients with acute myeloid leukemia(AML), in order to enhance the efficacy and reduce the adverse reactions, the observation of the clinical efficacy and tolerability of elderly patients with acute myeloid leukemia(AML), for the elderly patients with acute myeloid leukemia(AML) provides high efficiency, low toxicity of first-line treatment.Methods:Used experimental research method, according to the study of inclusion and exclusion criteria, from June 2013 to June 2015 the hospital blood hospital diagnosis and treatment of40 cases of acute myeloid leukemia(AML) patients as the research object, in accordance with the AML patients and the family’s wishes, incorporated into the study of 40 cases of acute myeloid leukemia(AML) patients divided into treatment group and control group, each group of 20 cases, the medical records of investigation, physical examination, laboratory examination and follow-up combined with complete data collection, through to the West with capecitabine combined with half the amount of CAG regimen in the treatment of elderly AML patients with clinical research, collect to the West with capecitabine combined with half dose of CAG regimen in the treatment of elderly patients with AML of the information. Establish a database with Epidata 3 software, using SPSS20.0 statistical software for data analysis.Measurement data if accord with normal distribution, the results to mean + standard deviation(mean + SD) said, compared with t test, if do not conform to the normal distribution, the median, quartiles, i.e. m(P25, P75), compared with non parametric test; categorical variables to number of cases(percentage)(n,%) said, the compared by chi square test(chi square test or the Fisher exact probability, survival was analyzed using Kaplan Meier survival analysis, and draw the survival curves, P < 0.05 for differences have statistical significance.Results:1 The study found that after treatment in treatment group were a course of treatment, CR45.00%, PR 45.00%, NR 10.00%, HI90.00%, 15 cases from blood transfusion. The total effective rate was 90.00%, gene methylation mutation positive CR 41.18%, PR47.06%, the total efficiency of 88.24%. The control after treatment of one course of treatment in patient group, 35.00% of CR, PR 25.00%, NR 40.00%, HI 60.00%, the total efficiency of 60.0% and PLT restored to normal in 6 cases, gene methylation mutation positive CR31.25%, PR25.00%,total have efficiency for 56.25%. After treatment in treatment group 2 courses and 55.00% CR,PR 40.00%, NR 5.00%, HI95.00%, 17 cases from blood transfusion, the total effective rate was 95.00%, gene methylation mutation positive CR, 47.06%, PR 47.06%, the total efficiency of was 94.12%. In the control group 2 courses of treatment, CR45.00%, PR25.00%,NR30.00%, hi 70.00%, the total efficiency of 70.0%, the recovery of PLT normal in 7 cases,gene methylation mutation positive CR43.75%, PR18.75%, total have efficiency was 62.50%.The statistical test showed that after 1 courses of treatment and after 2 courses of treatment,the total efficiency of treatment group, the total effective rate of methylation mutation positive patients were significantly higher than those in control group(P<0.05).2 The patients in the treatment group were lost in 2 cases, 1 cases died, the median disease-free survival time(DFS) and the median overall survival time(OS) were 12 and 19 months. The control group were lost in 3 cases, 2 cases died, the median disease-free survival time(DFS) and the median overall survival time(OS) were 6 and 13 months. The Kaplan-Meier analysis found that the treatment group survival and disease-free survival time(DFS) and overall survival(OS) was significantly longer than the control group and the difference was statistically significant(P<0.05).3 Treatment group and control adverse effects of treatment group including hematological toxicity and non hematological toxicity reactions, hematological toxicity reaction is mainly manifested as bone marrow suppression, neutropenia, thrombocytopenia, non blood toxicology reaction including complicated with pulmonary infection, fever, nausea, vomiting,abdominal distension, diarrhea etc. gastrointestinal tract reaction, liver function damage, oral ulcers, heart damage, sepsis, hemorrhage, hair loss and other. Treatment group granulocyte lack incidence, platelet reduce incidence were significantly lower than those in the control group, and had significant difference(P < 0.05), combination therapy and pulmonary infection, hair loss occurs rate higher than that of the control group but not found between the two groups has statistical difference(P>0.05), the treatment group, fever, nausea, vomiting,abdominal distension, diarrhea and other gastrointestinal reaction, liver function damage, oral ulcers, heart damage, sepsis, hemorrhage incidence was lower than that of the control group also was not found between the two groups has statistical difference(P > 0.05).Conclusions:West of capecitabine combined with half quantity of CAG regimen treatment in elderly patients with acute myeloid leukemia(AML) has better clinical effect than traditional CAG regimen and was significantly prolonged in elderly patients with acute myeloid leukemia(AML) for disease-free survival(DFS) and the median overall survival time(OS), also did not increase the adverse reaction, reduce bone marrow suppression of probability and severity,and bone marrow suppression time is short, low cardiac toxicity, tolerance is good. With the understanding of the pathogenesis of leukemia gradually, continue to develop new medicines and put into clinical trials, patients with AML treatment will appear new hope. |
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