改良Hyper-CVAD方案诱导治疗中老年p H阴性急性淋巴细胞白血病继发高血糖的临床研究 postprint

Abstract: Objective To investigate the effect of modified Hyper-CVAD therapy on elderly patients with p H negative acutelymphoblastic leukemia (ALL) secondary hyperglycemia and explore the relation between prognosis and hyperglycemia.Methods Seventy-two elderly patients (≥55) with p H -negative ALL were enrolled in the study. The patients were randomlydivided into 2 groups with 36 patients in each group. Patients in group A were performed with improved Hyper-CVADtherapy. Group B were performed with routine Hyper-CVAD therapy. The clinical features, secondary hyperglycemia and thesurvival status after chemotherapy were compared between the two groups before and after chemotherapy. The patients werefollowed up for 3 years. Results The random blood sugar of control group on the third weekend was higher than that of theobservation group, and higher than that of the first weekend in control group (P<0.05). Fasting blood glucose and bloodglucose were higher on the fourth weekend in the two groups than that in the first weekend (P<0.05). The random blood sugarin control group was significantly higher than that in observation group (P<0.05). There was no significant difference of fastingblood glucose between the two groups (P<0.05). The proportion of secondary hyperglycemia in control group was 22.22%,which is significantly higher than that of observation group(5.56%). There was no significant difference of recurrence rate andsurvival rate between the two groups. Fasting and random blood glucose on the fourth week of the two groups were correlatedwith infection, remission rate, relapse rate and overall survival rate.There were 11 and 14 cases recurred respectively in the twogroups, with no significant difference (30.56% vs 38.89%, P=0.458). Nine cases and 12 patients died respectively in the twogroups, with no significant difference(75.00% vs 67.67%, P=0.437). Conclusion The improved Hyper-CVAD therapy caneffectively reduce the risk of secondary hyperglycemia induced by chemotherapy on elderly patients with Ph-negative acutelymphoblastic leukemia.