老年急性白血病临床分析及个体化治疗探讨  

Clinical analysis and individualized treatment of old age acute leukemia

作　　者：李静[1] 罗瑞[1] 殷献录[1] 

机构地区：[1]安徽省蚌埠市第三人民医院血液科,233000

出　　处：《淮海医药》2009年第6期498-499,共2页Journal of Huaihai Medicine

摘　　要：目的探讨老年急性白血病的个体化治疗方案。方法对我院2000年1月～2007年12月收治的初治老年急性白血病患者（年龄≥60岁）74例临床资料进行回顾性分析。根据首次诱导缓解中化疗药物的剂量，将患者分为标准剂量或亚标准剂量组（A组）及减低剂量或小剂量组（B组），并对2组的疗效进行分析比较。结果可评价的A组24例；B组19例；完全缓解（CR）分别为37．5％，26．31％；总有效率分别为62．5％，73．68％；B组高于A组（P〈0．05）；平均生存期分别为176d，203d（P〈0．05）；平均骨髓抑制持续时间分别为23d，14d；不良反应发生分别为91％，87％（P〉0．05）；早期死亡（化疗相关性死亡）A组高于B组。结论老年急性白血病患者对化疗的耐受性差，诱导缓解治疗缓解率低，早期死亡率高，生存期短，治疗需采取比较具体的个体化治疗方案。减低剂量的化疗方案较适用于老年急性白血病患者。Objective To explore individualized chemotherapy program of elderly acute leukemia. Methods 74 patients aged≥60 years with acute leukemia from 2000 to 2007 were analyzed retrospectively. The first dosage as induced remission program taken into account,the patients were divided into two groups （ sub-standard dosage as group A and decreased dosage or low dose as group B）. The clinic efficacy of the two groups were compared and analyzed. Results Patients that could be e- valuated in group A were 24 eases and in group B were 19 cases. The complete remission （ CR ） of them were 37.5% and 26. 31%. The total effective rates were respectively 62. 5% and 73.68% ,with a higher percentage in group B than in group A. The mean survival time were 176 days and 203 days respectively （ P 〈 0. 05 ）. The bone marrow suppression duration time was 23 days and 14 days in group A and B respectively（ P 〈0. 05）. The side effect incidence for group A and group B was 91% and 87% （P〉0. 05）. Early death was higher in group A than in group B（chemotherapy-rclated death}. Conclusion The re- sponse of acute leukemia of the elderly people to chemotherapy is relatively poor,and they have a lower CR rate and shorter o- verall survival time. The patients should be treated individually. The chemotherapy regimen of decreased dose or lowred dose is suitable for old age acute leukemia.

关 键 词：急性白血病 个体化治疗 药物疗法 老年人 

分 类 号：R733.71[医药卫生—肿瘤]