摘要
目的探讨急性髓细胞白血病(AML)病人缓解后强化治疗阶段应用大剂量阿糖胞苷和多药交替化疗的效果。方法回顾性分析57例AML病人的临床资料,根据强化治疗阶段方案不同分为HD-Ara-C组(27例)和多药交替化疗组(30例),两组均以去甲氧柔红霉素+阿糖胞苷方案诱导至完全缓解,HD-Ara-C组采用大剂量阿糖胞苷治疗4疗程,多药交替组采用柔红霉素+标准剂量阿糖胞苷、高三尖杉酯碱+标准剂量阿糖胞苷或米托蒽醌+标准剂量阿糖胞苷等方案交替治疗4疗程,比较两组病人不良反应发生率、白血病细胞微小残留病变(MRD)及1年、3年总生存率、无病生存率。结果两组病人不良反应发生率比较差异无显著性(P>0.05)。HDAra-C组MRD阴性病人占81.5%(22/27),多药交替组为40.0%(12/30),两组比较差异有显著性(χ~2=10.159,P<0.05)。HD-Ara-C组病人1年及3年的总生存率及无病生存率均高于多药交替组,差异均有显著性(χ~2=4.657~9.156 P<0.05)。结论大剂量阿糖胞苷强化治疗能显著降低白血病细胞残留,提高病人1年和3年的总生存率和无病生存率,可作为AML病人诱导缓解后的优先治疗方案。
Objective To assess the efficacy of high-dose cytarabine（HD-Ara-C）and multi-drug alternating chemotherapy（MDAC）for intensive treatment of patients with acute myeloid leukemia（AML）after remission. Methods Clinical data of57 patients with AML were analyzed retrospectively.According to the different intensive treatment plan,the patients were divided into HD-Ara-C group（n=27）and MDAC group（n=30）.Patients in the two groups were all induced by IDA regimen to complete remission.Patients in the HD-Ara-C group received high-dose cytarabine therapy for four courses of treatment,and those in the MDAC group received multi-drug alternating chemotherapy-Daunorubicin＋ standard dose cytarabine,huperzine A ＋standard dose cytarabine or mitoxantrone＋standard dose cytarabine for four courses.Rates of adverse reactions,leukemia minimal residual disease（MRD）,one-year and three-year overall survival as well as disease-free survival（DFS）were compared between the two groups. Results The difference in incidence of adverse reactions between the two groups was not significant（P〉0.05）.The MRD negative patients accounted for 81.5 %（22/27）in HD-AraC group versus that for 40.0%（12/30）in multi-drug group,the difference was significant（χ^2=10.159,P〈0.05）.The one-year and three-year overall survival,as well as DFS in HD-AraC group were higher than that in the MDAC,the differences were significant（χ^2=4.657-9.156,P〈0.05）. Conclusion High-dose cytarabine intensive treatment can significantly reduce residual leukemic cells,increase one-year,three-year and overall survival,as well as disease-free survival,which can be used as the preferred treatment for patients with acute myeloid leukemia after induction remission.
出处
《齐鲁医学杂志》
2017年第1期17-19,22,共4页
Medical Journal of Qilu
关键词
白血病
髓样
急性
阿糖胞苷
治疗结果
leukemia
myeloid
acute
cytarabine
treatment outcome
