%0 Journal Article
%T 地西他滨治疗老年急性髓系白血病的疗效和安全性分析
%A 顾俊
%A 付强强
%A 陆弘逾
%A 张静芳
%A 万悦竹
%A 陈梅
%J 同济大学学报(医学版)
%D 2016
%R 10.16118/j.1008-0392.2016.04.019
%X 目的 系统评价地西他滨对老年急性髓系白血病(acute myeloid leukemia, AML)治疗效果和相关不良反应。方法 计算机检索PubMed、Embase、Ovid、CochraneLibrary、CNKI、VIP、万方、和CBM等电子数据库,查找地西他滨对比其他方案治疗老年AML的随机对照试验(RCT),检索时限均从建库至2015年10月。对符合纳入标准的RCT,由两位评价员按Cochrane系统评价的方法,独立进行资料提取、质量评价并交叉核对后,采用RevMan 5.3进行meta分析。结果 共纳入4个RCT,628例老年AML患者,试验组采用地西他滨,对照组采用其他疗法。Meta分析结果显示,与其他疗法比较,地西他滨治疗老年AML患者的完全缓解率更高(OR=2.44,95% CI:1.46~4.06,P=0.0006),部分缓解率差异无统计学意义(P＞0.05)；不良反应方面,地西他滨治疗组的Ⅲ/Ⅳ级粒细胞减少性发热发生率高于其他方案组(OR=1.77,95% CI:1.20~2.61,P=0.004),而两组的Ⅲ/Ⅳ级中性粒细胞减少、Ⅲ/Ⅳ级血小板减少、Ⅲ/Ⅳ级贫血的发生率差异无统计学意义(P＞0.05)。结论 现有研究证据显示,地西他滨治疗老年AML具有一定疗效,不良反应可耐受。</br>Objective To evaluate the effectiveness and safety of decitabine for older patients with acute myeloid leukemia. Methods Randomized controlled trials(RCTs) on decitabine in treatment of acute myeloid leukemia was searched from databases of PubMed, Embase, Ovid, Cochrane Library, CNKI, VIP, WanFang Data and CBM from inception to Oct, 2015. Two reviewers independently screened literature, extracted data, and assessed methodological quality. Then meta-analysis was conducted using RevMan 5.3 software. Results A total of 4 RCTs involving 628 patients were finally included. The trial arm was given decitabine while the control arm was given other therapies. The results of meta-analysis showed that for elderly patients with acute myeloid leukemia, decitabine produced a better complete remission(CR) rate than other therapies[OR=2.44,95% CI:1.46~4.06,P=0.0006], while the partial remission(PR) rate had no statistically significant difference between two arms(P＞0.05). In terms of adverse events, the incidence of grade Ⅲ or Ⅳ febrile neutropenia in decitabine arm was significantly higher than that in other therapies(OR=1.77,95% CI:1.20~2.61,P=0.004). The incidences of grade Ⅲ or Ⅳneutropenia, grade Ⅲor Ⅳthrombocytopenia, and grade Ⅲ or Ⅳ anemia were not statistically different between two arms(P＞0.05).Conclusion Current evidence suggests that decitabine achieved a higher CR rate, with comparable hematological side effects for elderly patients with AML
%K 地西他滨 急性髓系白血病 老年人 meta分析&lt
%K /br&gt
%K decitabine acute myeloid leukemia older patients meta-analysis
%U http://tjyxxb.cnjournals.cn/ch/reader/view_abstract.aspx?file_no=20160419&flag=1