摘要
目的评价小剂量、超小剂量及标准剂量化疗治疗老年人急性髓系白血病（AML）的疗效，寻找小剂量化疗的适应证。方法回顾性分析1993年1月至2008年11月收治的77例年龄≥60岁AML患者的病例资料，分析小剂量、超小剂量和标准剂量化疗的近期和远期疗效。结果总样本中小剂量、超小剂量组患者的年龄较大、PS评分较高、白细胞较低，但与标准剂量组比，完全缓解（CR）率、总有效率（ORR）、无事件生存（EFS）率和总生存（OS）率差异均无统计学意义。按照年龄或PS评分细分亚组，小剂量、超小剂量组在〈70岁和PS评分≤2的亚组中，不论近期、远期疗效都明显优于标准剂量组；而在≥70岁和PS评分〉2的亚组中，两组疗效差异无统计学意义。进一步分析显示：小剂量化疗并未减少化疗相关死亡，也未增加远期复发的风险。结论小剂量、超小剂量化疗与标准剂量化疗相比可以改善老年AML患者的预后，而且更适用于年龄较轻、一般情况较好的部分老年患者。
Objective To evaluate the therapeutic effect of low-dose, ultra-low-dose and standarddose chemotherapy for elderly acute myeloid leukemia. Methods A retrospective analysis was performed on 77 elderly AML patients aged 60 years or older. The short-term and long-term effects were compared among low-dose, uhra-low-dose and standard-dose chemotherapy. Results Although patients receiving low-dose or ultra-low-dose chemotherapy were older, with higher PS scores and lower WBC count, there were no significant differences in CR rate, ORR, EFS or OS between patients who received low-dose/ultra-low-dose chemotherapy and standard-dose chemotherapy. By dividing the total samples into subgroups according to age or PS scores, we found out that patients younger than 70 or with a PS score less than 2 showed a much better prognosis, no matter short-term or long-term, in low-dose/ultra-low-dose group rather than in the standarddose group. While in those patients older than 70 or with a PS score more than 2, the differences between those two groups were not significant. Further analysis showed that low-dose chemotherapy did not reduce treatment related mortality, neither did it increase the risk of long-term relapse. Conclusion Low-dose and ultra-low-dose chemotherapy can improve the prognosis of elder AML patients compared with standard-dose chemotherapy, especially for elderly patients who have a better general state.
出处
《白血病．淋巴瘤》
CAS
2009年第12期725-728,共4页
Journal of Leukemia & Lymphoma
关键词
白血病
髓样
急性
老年人
药物疗法
联合
Leukemia, myeloid, acute
Aged
Drug therapy, combination
