FLAG方案治疗成人难治复发急性白血病20例临床观察  

The therapeutic effect of FLAG regime for refractory or relapsed acute leukemia

作　　者：郑培浩[1] 陶颖[1] 

机构地区：[1]海军总医院干部保健科,北京100048

出　　处：《海军总医院学报》2011年第4期199-201,共3页Journal of Naval General Hospital of PLA

摘　　要：目的探讨FLAG方案(氟达拉宾、阿糖胞苷和非格司亭联合应用)治疗成人难治复发急性白血病(acute leukemia,AL)的疗效及不良反应。方法对20例成人难治复发AL患者采用FLAG方案化疗,观察疗效及其不良反应。氟达拉宾50mg/d,静脉滴注,持续30min,第1～5天;阿糖胞苷0.5～1.0g/(m2.d),每12h1次,氟达拉宾后4h,静脉滴注,第1～5天;非格司亭300μg/d,皮下注射(氟达拉宾前1h,第0～5天)。结果完全缓解(complete remission,CR)率为55%,部分缓解(partial remission,PR)率为20%,总有效(overall response,OR)率为75%;CR病例中71.8%为1个疗程缓解。难治组、复发组的CR率和OR率差异均无统计学意义(P>0.05)。急性淋巴细胞白血病、急性髓细胞白血病和急性混合细胞白血病组间CR率和OR率差异也无统计学意义(P>0.05)。FLAG方案的不良反应主要为骨髓抑制及继发感染等,但绝大多数患者经治疗和间歇期后均能恢复。结论 FLAG方案对成人难治复发AL的治疗缓解率相对较高,不良反应可以接受,多用于一般状况较好的年轻人,是成人难治复发AL首选治疗方案之一。Objective To investigate the efficacy and side effects of the regimen combined with fludarabine,cytarabine and filgrastim（FLAG）for refractory or relapsed patients with acute leukemia（AL）.Methods A total of 20 patients with AL were enrolled to treat with FLAG regimen,then observed the efficacy and side effects.Fludarabine 50 mg/d,intravenous drip（VD） lasts 30 min 1-5 days.Cytarabine 0.5―1.0 g/m（2） on day 1,every 12 hours at a time,after the fludarabine 4 h,VD,1-5 days.Filgrastim 300 μg/d,subcutaneous injection（fludarabine before 1 h,0-5 days）.Results The rate of CR,PR and OR was 55%,20% and 75% respectively.71.8% of CR occurred after the first course with such regimen.There were no disparities between the groups of ALL,AML and MAL（P0.05）.The main side effects were severe myelosuppression and infection due to neutropenia.But mostly patients could be recovered after treatment during the intermission.Conclusion FLAG regimen is effective and well-tolerated treatment for patients with refractory and relapsed acute leukemia,especially for younger patients.It is one of the prefered regimens to treat refractory or relapsed acute leukemia.

关 键 词：急性白血病 氟达拉宾 阿糖胞苷 非格司亭 

分 类 号：R733.71[医药卫生—肿瘤]