Observation On The Efficacy Of Descitabine Combined With HAG,Thalidomide And Ubenimex In Newly Diagnosed Treatment Of Senile Acute Myeloid Leukemia

Objective:In this thesis,we observed the efficacy of Descitabine combination with HAG,Thalidomide,and Ubenimex in newly diagnosed treatment senile(age?65years)Acute Myeloid Leukemia(AML).Methods:Collected in January 2016-October 2019 in Hebei Engineering University Affiliated Hospital blood internal medicine diagnosis and treatment of 115cases of eligible elderly patients with AML(except APL)clinical data,were retrospectively analyzed,which is applied to Descitabine in combination with HAG,Thalidomide,and Ubenimex for the observation group,used the HA,AA,DA and MA routine chemotherapy regimens for the control group.After 2 courses of chemotherapy,the efficacy and adverse reactions of the two groups were calculated.Results:1.There were 59 cases in the observation group and 56 cases in the control group,before treatment,there were no significant differences in sex,age,number of patients with underlying diseases,pulmonary infection,bleeding,WBC,HGB,Plt,ALT,Cr,LDH,chromosomal abnormalities,bad prognosis gene mutation,number of WT1 positive patients,serum VEGF level,serum T cell count(CD3+,CD4+,CD8+,CD4+/CD8%)and NK cell count between the two groups(P>0.05)?2.After two courses of chemotherapy,the CR rate and PR rate were 47.5%and 28.8%in the observation group,35.7%and 23.2%in the control group,respectively,with no significant difference(P>0.05);the total response rate was 76.3%and 58.9%respectively,with significant difference(P<0.05).Serum VEGF level:in the observation group,302.74±62.18pg/ml before treatment,134.68±41.77pg/ml after treatment,P<0.01;in the control group,299.96±50.83pg/ml before treatment,221.45±65.06pg/ml after treatment,P<0.01;before and after treatment,there was significant difference in serum VEGF level between the two groups(P<0.01).Serum T cell and NK cell count:before treatment,the CD3+count was 42.64±6.97%,40.91±8.70%,after treatment,69.64±6.11%,52.18±9.62%;before treatment,the CD4+count was 15.24±3.51%,14.64±4.07%,after treatment,34.58±4.83%,20.98±6.76%;before treatment,the CD8+count was 65.01±5.66%,62.64±8.36%,after treatment,38.01±4.08%,51.39±6.77%;CD4+/CD8+before treatment were 0.56±0.28,0.60±0.11,respectively,after treatment were 1.81±0.59,1.07±0.34;NK cell number before treatment were 10.15±4.88%,11.60±3.06%,respectively,after treatment were31.08±3.35%,20.49±4.77%;after treatment,there was a statistically significant difference between the two groups(P<0.01);there were statistically significant differences between the two groups before and after treatment Academic significance(P<0.01).3.Adverse reactions:the incidence of WBC<1.0×10~9/L,neutrophil<0.5×10~9/L,Plt<10×10~9/L was 22.0%VS 82.1%,13.6%VS 87.5%,28.8%VS 48.2%respectively,P<0.05,the difference was statistically significant.Before and after treatment,the rate of ALT change and LDH change was 16.9%VS 33.9%and6.8%VS 19.6%respectively,P<0.05,the difference was statistically significant;before and after treatment,the rate of Cr change was 0.0%VS 5.4%,P>0.05,the difference was not statistically significant.Before and after treatment,the incidence of pulmonary infection and other infection in the two groups was 18.6%VS 37.5%,6.8%VS 19.6%,the incidence of bleeding in the two groups was 5.1%VS 19.6%,P<0.05,the difference was statistically significant;the mortality of the two groups were 3.4%VS 5.4%,P>0.05,the difference was not statistically significant.The per capita red blood cell transfusion was 2.75U,3.93U,and the per capita platelet transfusion was 1.27 and 2.16,P<0.05,the difference was statistically significant.Conclusions:1.Compared with the conventional chemotherapy,the new therapy combined with multiple mechanisms can reduce the angiogenesis,reverse the drug resistance,enhance the immune function,improve the efficiency,reduce the incidence of bone marrow suppression,lower blood cells,reduce the blood transfusion per capita,and cause adverse events such as infection,bleeding,organ damage The rate of birth is low,the patient's tolerance is good,and the quality of life is improved.2.It is recommended for the elderly AML with poor physical condition,multiple complications and organ dysfunction.