FLAG方案治疗难治性和复发性急性白血病的临床分析  

FLAG regimen in the treatment of refractory/relapsed acute leukemia

作　　者：张新友[1] 徐肇明[1] 许瑞莲 吴铭[1] 姜容[1] 陈晓琳[1] 王伏田[1] 

机构地区：[1]深圳市人民医院暨南大学医学院第二附属医院血液科,518020

出　　处：《白血病．淋巴瘤》2007年第3期199-200,203,共3页Journal of Leukemia & Lymphoma

摘　　要：目的观察由氟达拉滨(Flud)、阿糖胞苷(Ara-C)、粒细胞集落刺激因子(G-CSF)组成的FLAG方案治疗难治性、复发性急性白血病(AL)的疗效及毒副作用。方法用FLAG方案治疗复发性ALL 7例,难治性和复发性AML3例,慢性粒细胞白血病(CML)急变2例。结果5例(42%)获完全缓解(CR),1例部分缓解(PR),且均为复发ALL。每个疗程均出现Ⅳ度血液学毒性,74%、48%疗程分别有发热、出血。治疗相关性死亡率17%。非血液学毒性主要有恶心(或呕吐)、腹泻、睑结膜充血、皮疹或皮肤潮红、一过性肝损害、药物性发热。结论FLAG方案对复发和难治性AL有一定的疗效。骨髓毒性严重,非血液学毒性轻微。Objective To evaluate the efficacy and toxicity of the combination of fludarabine(Flud), cytosine arabinoside (Ara-C),and granulocyte colony-stimulating factor (G-CSF)(FLAG) in refractory/relapsed acute leukemia (AL) patients.Methods 12 patients were treated with FLAG regimen (relapsed ALL,seven; relapsed AML,one;refractory AML,tow;CML-blast phase,tow).Results 5 patients (42 %) and 1 patient achieved complete remission (CR) and partial remission (PR),respectively,and all of the responders were the patients with relapsed ALL.GradeⅣhematologic toxicity occurred in all chemotherapeutic courses.Neu- tropenic fever was seen in 74 % of courses,bleeding 48 %.There was a 17 % incidence of treatment-related deaths.Nonhematological side effects,consisting mainly of nausea/vomiting,diarrhea,conjunciva congest,rash or flush skin,liver toxicity and drug fever,were generally tolerated.Conclusion Hematologic toxicity of FLAG regimen is sever,the other mild.It is effective regimen in relapsed/refractory AL,enabling patients to receive further transplantation procedures.

关 键 词：白血病 混合细胞 FLAG方案 

分 类 号：R733.71[医药卫生—肿瘤]