氟达拉滨联合阿糖胞苷方案治疗复发及难治性急性髓系白血病的临床研究  

Clinical Study on Fludarabin Combined with Cytarabine Regimen in the Treatment of Patients with Refractory and Relapsed Acute Myeloid Leukemia

作　　者：姚一芸[1] 朱琦[1] 邹丽芳[1] 窦红菊[1] 程毅敏[1] 唐勇[1] 胡钧培[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院血液科,上海200011

出　　处：《中国实验血液学杂志》2009年第3期774-776,共3页Journal of Experimental Hematology

摘　　要：本研究探讨氟达拉滨联合阿糖胞苷(FA)方案对复发及难治性急性髓系白血病(AML)的临床疗效和不良反应。选择我院治疗的19例复发及难治性AML患者,应用FA方案:氟达拉滨25mg/(m2·d),静脉滴注,第1-5天;4小时后给予阿糖胞苷2g/(m2·d),静脉滴注,第1-5天。另20例选用对照方案:MAE或DAE方案化疗,MAE方案即米托蒽醌8mg/(m2·d),第1-3天;阿糖胞苷200mg/(m2·d),第1-7天;依托泊甙60mg/(m2·d),第1-5天。DAE方案即柔红霉素45mg/(m2·d),第1-3天;阿糖胞苷200mg/(m2·d),第1-7天;依托泊甙60mg/(m2·d),第1-5天。各组均重复2个疗程。结果表明:2疗程后FA方案组完全缓解(CR)9例(47%),部分缓解(PR)8例(42%);对照方案组CR5例(25%),PR6例(30%)。两组差异率有统计学意义(p<0.05)。所有FA方案组患者均发生IV级骨髓抑制现象,明显强于对照组(p<0.05),其他非血液系统不良反应包括胃肠道反应、粘膜炎、肝功能损伤;大多数不良反应能被患者耐受,FA组与对照组无显著差异。结论:FA方案是复发及难治性AML的有效挽救治疗方案。The aim of study was to evaluate the clinical efficacy and toxicity of fludarabin combined with cytarabine （FA） regimen in the treatment of patients with refactory and/or relapsed acute myeloid leukemia （AML）. Nineteen cases with refactory/relapsed AML were treated with FA regimen in which fludarabine phosphate 25 mg/（ m2 · d）, dl -5; cytarabine （Ara- C） 2 g/（m2 · d）, d1 -5. Another 20 eases were treated with salvage chemotherapy（ MAE regimen： mitoxantrone, Ara-C and etoposide or DAE regimen： daunorubicin, Ara-C and etoposide）. All patients received at least 2 cycles chemotherapy. The results showed that 9 patients （47%） in FA regimen group achieved complete remission （CR）, 8 cases （42%） obtained partial remission （PR）, the clinical efficacy was superior to that of the MAE or DAE regemins （p 〈 0.05 ）. Major toxicity of FA regimen was myelosuppression. Grade IV hematologic toxicity occrrred in all patients received FA regimen. Nonhematologic complications consisted of gastrointestinal side effects, mucositis, liver toxicity, which were mild to moderate and could be alleviated with supportive therapy. In conclusion, FA regimen is an effective regimen for treatment of refactory and relapsed AML.

关 键 词：AML 复发难治性AML FA方案 

分 类 号：R733.71[医药卫生—肿瘤] R979.1[医药卫生—临床医学]