摘要
目的 评估Pfiming Therapy方案治疗复发、难治和继发性急性髓细胞白血病（AML）的疗效。方法 予粒细胞集落刺激因子[（G—CSF，200μg／（m^2·d），第1～14天，皮下注射）]、低剂量阿糖胞苷[（Ara—C，10mg／（m·d），d1-14，每12h皮下注射）]和阿克拉霉素[（Acla，5～7mg／（m^2·d），d1～8，静脉注射）]或高三尖杉酯碱[（HHT，1mg／（m^2·d），d1～8，静脉注射）]在内的Priming Therapy方案治疗复发、难治及继发性AML患者25例。结果 14例一个疗程CR，CR率56％，5例2个疗程CR，总有效率达76％，6例治疗无效，其中4例为复发病例，1例为标准常规化疗未取得缓解的病例，1例为老年低增生白血病，并可见粒细胞缺乏、血小板减少、继发感染及发热等不良反应。结论 G—CSF可促进AML细胞的增殖和分化、增强化疗药物在细胞内的代谢及对白血病细胞的毒性作用，是本方案取得较高缓解率而毒副反应较少的理论基础。本方案治疗复发、难治和继发性急性髓细咆白血病安全有效。
Objective To evaluate the effect of Priming Therapy regimen on acute myeloid leukemia（AML） . Methods 25 patients with AML （median age 52 , range 39 - 82） enrolled were treated with Priming Therapy regimen consisting of low- dose cytosine arabinoside （Ara- C , 10 mg·m^-2·d^-1, q 12 h ; day 1 - 14 , subcutaneously） , aclarubicin （Acla , 5 - 7mg·m^-2·d^-1 ; day 1- 8, iv） or homoharringtonine（ HHT, I mg·m^-2·d^-1, d 1-8, iv ） , and concurrent use of granulocyte colony - stimulatingfaetor （ G - CSF , 200μg·m^-2·d^-1, subcutaneously , day 1-14） . Results 14 of 25 patients achieved complete remission , and 5 partial remission with a total remission rate of 76 %, adverse effec.ts were agranttlocytosis , thxnmbocytopenia, secondary infection and fever. Myelosuppression presenting as granulocytopenia , complicating infection , and thrombocytopenia were the most significant toxicity in this regimen. Conclusion G - CSF enhances the proliferation and differentiation of leukemic cells , and increases the intracellular metabolism of the chemotherapeutic agents and their cytotoxity for leukemic cells. It is a safe and effective regimen in treating recurrent , refractory and secondary Acute myelocytic leukemia.
出处
《浙江临床医学》
2006年第9期914-915,共2页
Zhejiang Clinical Medical Journal
