摘要
目的：探讨慢性粒单核细胞白血病（CMML）的疾病特点及中西医结合治疗疗效。方法：回顾性分析10例CMML的临床特点、中西结合治疗和生存情况。结果：临床特点：男性为主，中老年多见，年龄30-80岁，中位年龄48岁。常见乏力、肝脾肿大等症状，其他表现多样，缺乏特异性。治疗方法：所有患者均服用参芪白血饮（专科自拟协定处方），配合中成药以解毒抗癌、扶正补虚、活血化瘀施治。具体治法：单纯中药治疗1例，中西结合治疗9例：其中5例联合羟基脲，4例联合静脉化疗，2例同胞全相合异基因造血干细胞移植。生存分析：总体中位生存期9个月，1年OS：40％；结合世界卫生组织（WHO）诊断分型分析预后：CMML-I型2例，平均生存时间17．5个月：CMML-II型8例，中位生存时间8．5个月；按美国M．D．Anderson预后评分标准中位生存时间为：中危1型2例：17．5个月；中危2型6例：8．5个月；高危2例：7个月；移植患者均无病生存至今，最长已达21个月。结论：CMML是一种异质性疾病，益气养阴、健脾补。肾、活血解毒中药治疗老年中危I型有望获得明显效果，年轻患者以化疗、移植为主，辅以和解、补益中药，可提高疗效。
Objective ： To evaluate the features and the efficacy of the integrated traditional Chinese and western medic.ine on patients with the chronic myelomonocytic leukemia （ CMML ）. Method： Retrospective analysis of the clinical features and survival time of 10 cases of CMML was carried on. Results： Clinical characteristics ： male-dominated, more common in the elderly, age 30-80 years, with a median age of 48 years old. Common symptoms were weakness and hepatosplenomegaiy, while others were lack of specificity. Therapy： all patients took the Shenqi Baixue Drinking （ the specialist self-agreement prescription ） and some Chinese patent medicine to detoxify cancer, righting toxin, blood circulation differentiation. Specific treatment： One patient received pure traditional Chinese medicine treatment, while the other 9 patients received the combination therapy of integrated traditional Chinese and western medicine （ five joint hydroxyurea, four intravenous chemotherapy, two compatriots consistency allogeneic hematopoietic stem cell transplantation ） .Survival analysis ： the overall median survival time was 9 months, 1 year OS ： 40%. Prognosis analysis by the World Health Organization （ WHO ）diagnostic genotyping： two cases were CMML-I type, with an average survival lime of 17.5 months, 8 cases were CMML-Ⅱ type, with a median survival time of 8.5 months. Median survival time according to the United States M.D.Anderson prognostic： score criteria： 2 cases with median-risk type 1 were 17.5 months,6 cases with median-risk type 2 were 8.5 months, and 2 cases on high risk were 7 months, while patients receiving the transplant therapy were disease-free until now with a longer time of 21 months. Conclusions ： CMML is a heterogeneous disease. The traditional Chinese medicine therapy may improve the outcomes in the elderly patients with median-risk type I, while the young patients should be treated mainly with chemotherapy and transplant, supplemented by reconciliation, tonic medicine.
出处
《辽宁中医药大学学报》
CAS
2013年第6期198-200,共3页
Journal of Liaoning University of Traditional Chinese Medicine
关键词
慢性粒单核细胞白血病
中西医结合
造血干细胞移植
chronic
myelomonocytic leukemia
integrated traditional Chinese and western medicine
hematopoietic stem cell transplantation
