MA方案诱导治疗急性髓系白血病的疗效及其预后因素分析  

Analysis of outcome and prognosis-related factors of MA regimen for acute myeloid leukemia

作　　者：孙海英[1] 耿华云[2] 张璞[1] 杨宇娟[1] 闫志凌[1] 徐开林[1] 

机构地区：[1]徐州医学院附属医院血液科,221002 [2]淮北市人民医院血液科

出　　处：《白血病．淋巴瘤》2010年第11期669-671,共3页Journal of Leukemia & Lymphoma

摘　　要：目的 研究MA方案诱导治疗急性髓系白血病（AML）患者的治疗效果及影响预后的相关因素.方法 对初治原发AML患者102例,采用MA方案（米托蒽醌＋阿糖胞苷）诱导治疗,观察其治疗效果及不良反应.根据患者年龄、白细胞计数、FAB分型、乳酸脱氢酶（LDH）水平以及免疫表型进行分组,分析影响预后的相关因素.结果 经1个疗程的MA方案诱导治疗后,完全缓解（CR）65例（63.73%）,部分缓解（PR）18例（17.65%）,未缓解（NR）19例（18.62%）,总有效（PR＋CR）率为81.38%.年龄＜60岁、白细胞计数＜100×109/L、FAB分型为M2、LDH＜600 U/L者的CR率及总有效率较≥600 U/L组高,差异有统计学意义（P＜0.05）,CD＋7与CD-7组相比仅CR率差异有统计学意义（P＜0.05）,而CD19与CD-19组相比CR率及总有效率差异均无统计学意义（P＞0.05）.结论 采用MA方案诱导治疗AML具有较好的疗效,不良反应少.患者年龄、白细胞计数、FAB分型、LDH水平以及CD7的表达是影响治疗效果的预后相关因素.Objective To analyze the outcome and prognosis-related factors of MA （mitoxantrone＋cytarabine） regimen for acute myeloid leukemia（AML）. Methods 102 untreated AML patients were treated with MA. All patients were divided into two groups according to age, blood white cell count（WBC）, FrenchAmerican-British （FAB） morphology, level of lactate dehydrogenase （LDH） and immunophynotype respectively.Analyze the prognosis-related factors. Results The complete remission （CR）, partial remission （PR）, nonresponse （NR） rate, and remission rate （CR＋PR） of all the 102 cases were 63.73 % （65/102）, 17.65 % （18/102）, 18.62 % （419/102）and 81.38 % （83/102） respectively. The patients younger than 60 years old, WBC〈100×109/L, LDH≤600 U/L, FAB-M2 morphology group had higher CR and remission rate. The CR rate of patients with CD7 positive had statistical difference from that of patients with CD7 negative （P 〈0.05）, but the remission rate not. However, the CR and remission rate of patients with CD19 positive had no statistical difference from that of patients with CD19 negative （P 〉0.05）. Conclusion These results suggest that use of MA regimen was effective and safe for AML. Age, WBC, FAB morphology, level of LDH and CD7 expression are prognosis-related factors for clinical outcome.

关 键 词：白血病 髓样 急性 抗肿瘤联合化疗方案 米托蒽醌 

分 类 号：R733[医药卫生—肿瘤]