摘要
为探讨小剂量化疗联合粒细胞集落刺激因子(CAG预激方案)治疗复发急性髓细胞白血病(AML)的疗效和不良反应,采用CAG治疗50例AML复发患者,其中13例早期复发,37例为晚期复发;7例为异基因造血干细胞移植(allo-PBSCT)后复发,3例自体造血干细胞移植(auto-PBSCT)后复发,25例已接受过含中大剂量Ara-C方案巩固治疗后复发,15例患者CR后或巩固治疗过程中自停继续化疗后复发。30例接受CAG治疗,20例接受常规剂量的一种蒽环类抗生素联合阿糖胞苷治疗(对照组)。结果表明:1个疗程后CAG组完全缓解(CR)14/30例(46.7%),3/6例allo-PBSCT后复发患者获CR,1例(3.3%)早期死亡;对照组CR为6/20(30%),3例(15%)早期死亡。CAG组和对照组的总生存期中位时间分别为22个月(5.5月-85月)和19个月(7-120个月)。化疗的毒副作用主要为骨髓抑制,未见严重的非造血系统毒副作用。结论:CAG方案为复发AML的一种有效方案,对于已接受过大剂量化疗或移植的患者易于接受,化疗的毒副作用相对小。
To evaluate the efficacy and toxicity of low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor （G-CSF） protocol for patients with relapsed acute myeloid leukemia （AML）. A total of fifty relapsed patients have been enrolled, including 13 early relapsed and 37 late relapsed. 24 patients were male and 26 were female, with age ranging from 15 to 69 （median 47 ） years. Out of them, 7 patients relapsed after allogeneic peripheral blood stem cell transplantation （allo-PBSCT）, 3 patients relapsed after autologous peripheral blood stem cell transplantation （auto-PBSCT）, 25 patients relapsed after received regimens including high dose cytarabine and 15 patients relapsed after CR or stopping chemical therapy themself in course of consolidatory therapy. 30 relapsed patients received CAG regimen, and 20 patients （control group ） received an anthracycline in combination with cytarabine. The results indicated that after one course, the complete remission （CR） rate was 46.7% （ 14/30）, the CR rate after allo-PBSCT was 50% （3/6）, the early death rate was 3.3% in CAG group; and CR rate was 30% （6/20） and the early death rate was 15% in control group. Myelosuppression was mild to moderate, and no severe nonhematologic toxicity was observed in two groups. The overall median times in CAG group and control group were 22 and 19 months respectively. In conclusion, CAG regimen as the induction therapy is effective and well tolerable with low side effects for relapsed patients who had received high dose cytarabine, auto-PBSCT or allo-PBSCT.
出处
《中国实验血液学杂志》
CAS
CSCD
2009年第3期760-764,共5页
Journal of Experimental Hematology
基金
江苏省卫生厅医学科研课题,编号H200703
关键词
急性髓系白血病
复发
阿克拉霉素
粒细胞集落刺激因子
acute myeloid leukaemia, relapsed
cytarabine
aclarubicin
granulocyte colony-stimutating factor
