Myelodysplastic syndrome-refractory thrombocytopenia treated by dose-reduced decitabine
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摘要: 目的：总结减低剂量的地西他滨治疗3例骨髓增生异常综合征-难治性血小板减少（MDS-RT）患者的诊疗体会。方法：起始3例患者均行减低剂量地西他滨治疗1疗程：20 mg/m2，静脉滴注1 h，qd×3 d，之后患者2巩固3疗程，患者3转用免疫抑制剂治疗。结果：1疗程结束后，患者1血小板3×109/L升为50×109/L，患者2血小板5×109/L升为45×109/L，均脱离输注，患者3仍未脱离输注，免疫抑制剂治疗无效，后进展为急性单核细胞白血病。结论：减低剂量地西他滨治疗低危的MDS-RT可改善血小板减少、血小板输注依赖问题，且不良反应少，值得在大样本的临床实验中检验其疗效。
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关键词:
- 骨髓增生异常综合征-难治性血小板减少 /
- 地西他滨 /
- 减低剂量
Abstract: Objective: To summarize the experience of dose-reduced decitabine in treating 3 patients with myelodysplastic syndrome-refractory thrombocytopenia (MDS-RT).Method: Dose-reduced decitabine was used to treat 3 patients with MDS-RT for the first course:20 mg/m2, iv 1 h, qd×3 d.Then No.2 patient went on to get decitabine-treatment for 3 courses and No.3 patient chose immunosuppressive therapy.Result: The platelet count of No.1 patient increased from 5×109/L to 45×109/L after one course treatment and the platelet count of No.2 patient increased from 5×109/L to 45×109/L.These two patients both got rid of platelet transfusion and the count of platelet was stable in the following 6 months.No.3 Patient still depended on platelet transfusion and transformed into AML-M5 in the next 5 months.Conclusion: Dose-reduced decitabine treating MDS-RT may ameliorate platelet transfusion dependence and thrombocytopenia, while its side-effect is not serious.Moreover, the efficiency of decitabine need to be tested in large sample study. -
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