Đặc điểm lâm sàng, xét nghiệm và đánh giá sơ bộ hiệu quả điều trị bạch cầu cấp dòng tủy ở người cao tuổi bằng decitabine đơn độc tại bệnh viện Trung ương Quân đội 108 năm 2022-2024=Clinical characteristics, laboratory test and assessment of preliminary effectiveness of treating acute leukemia in the elderly with decitabine alone at 108 Military Central hospital in 2022-2024

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Thu Huyền Lê, Thanh Bình Nguyễn, Thị Thùy Trang Nguyễn, Thị Tuyết Nhung Phạm, Văn Hiệu Phạm, Thị Thanh Long Phan

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.125-134

Bộ sưu tập: Metadata

ID: 478224

Thêm vào giỏ

Describe the clinical and laboratory characteristics of elderly acute myeloid leukemia patients treated with Decitabine alone at 108 Military Central Hospital from January 2022 to June 2024 and comment on the treatment outcomes in these patients. Research subjects:: 25 patients ≥60 years old with newly diagnosed acute myeloid leukemia treated with Decitabine alone. Methods: Cross-sectional descriptive study, noncontrolled clinical intervention, longitudinal follow-up, prospective. Results: The average age of onset was 70.68 ± 7.32, with a male to female ratio of 2.125:1. The clinical status according to PSECOG ≥2 was 18 (72%), with a Charlson comorbidity index (CCI) ≥3 of 100%, 56% of patients had an infection at the time of diagnosis, 80% of patients required red blood cell transfusion, and 36% required platelet transfusion. Regarding laboratory tests, the average % of bone marrow blasts was 39.16 ± 18.63, the median blood blasts was 8%, the median peripheral blood leukocytes was 6.8 G/L, with grade III-IV neutropenia of 48%. In 16 patients evaluated at the start of cycle 2, the need for red blood cell transfusion decreased from 75% to 50%, the need for platelet transfusion decreased from 37.5% to 31.25%, however, the rate of neutropenia increased from 37.5% to 43.75%, 60% of patients reported infection, and pneumonia was still the most common infection both before and after treatment, at 36% and 44%, respectively. In 8 patients treated for 4 or more cycles, the complete response rate was 25%, and the clinical benefit rate was 50%. Conclusion: Our study contributes to increasing the understanding of clinicians about the characteristics of elderly acute myeloid leukemia patients and the treatment process of Decitabine in this patient population.Mô tả đặc điểm lâm sàng, xét nghiệm của bệnh nhân bạch cầu cấp dòng tủy ở người cao tuổi được điều trị bằng Decitabin đơn độc tại Bệnh viện Trung ương Quân đội 108 từ tháng 1/2022 -tháng 6/2024 và nhận xét kết quả điều trị ở những bệnh nhân trên. Đối tượng nghiên cứu: 25 bệnh nhân ≥ 60 tuổi được chẩn đoán bạch cầu cấp dòng tủy mới chẩn đoán điều trị Decitabin đơn độc. Phương pháp: Nghiên cứu mô tả cắt ngang, can thiệp lâm sàng không đối chứng theo dõi dọc, tiến cứu. Kết quả: Tuổi mắc bệnh trung bình là 70,68 ± 7,32, trong đó nam, nữ với tỷ lệ 2,125:1. Thể trạng lâm sàng theo PSECOG ≥2 là 18 (72%), với chỉ số bệnh đi kèm Charlson (CCI) ≥3 là 100%, có 56% bệnh nhân có tình trạng nhiễm khuẩn tại thời điểm chẩn đoán, bệnh nhân có nhu cầu truyền hồng cầu cao tới 80%, truyền tiểu cầu 36%. Về xét nghiệm, trung bình % blast tủy 39,16 ± 18,63, trung vị blast máu 8%, trung vị bạch cầu máu ngoại vi 6.8 G/L, với giảm bạch cầu trung tính độ III-IV 48%. Trong 16 bệnh nhân được đánh giá tại thời điểm bắt đầu điều trị chu kì 2, nhu cầu truyền hồng cầu giảm từ 75% xuống còn 50%, nhu cầu truyền tiểu cầu giảm từ 37,5% xuống còn 31,25%, tuy nhiên tỉ lệ giảm bạch cầu trung tính tăng từ 37,5% lên 43,75%, có 60% bệnh nhân có ghi nhận tình trạng nhiễm trùng và viêm phổi vẫn là nhiễm trùng thường gặp nhất cả trước và sau điều trị lần lượt là 36% và 44%. Trong 8 bệnh nhân điều trị từ 4 chu kì trở lên, tỷ lệ đáp ứng hoàn toàn là 25%, và tỷ lệ lợi ích lâm sàng là 50%. Kết luận: Nghiên cứu của chúng tôi góp phần gia tăng hiểu biết cho các bác sĩ lâm sàng về đặc điểm nhóm bệnh nhân bạch cầu cấp dòng tủy người cao tuổi và quá trình điều trị Decitabin trên đối tượng bệnh nhân này.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR