CAT方案治疗难治/复发性急性髓系白血病的临床观察  

Treatment of refractory acute leukemia with cyclophophamide,Ara-c,and topotecan combination regimen

作　　者：周学慧[1] 王社论[1] 翟树森[1] 张军[2] 张瑞萍[1] 高云阁[1] 雷琰[1] 崔庆超[1] 

机构地区：[1]中国人民解放军第306医院血液肿瘤科,北京100101 [2]中国人民解放军306医院病理科

出　　处：《临床血液学杂志》2012年第3期314-316,共3页Journal of Clinical Hematology

摘　　要：目的:初步观察CAT(环磷酰胺、阿糖胞苷、拓扑替康)方案对难治/复发急性髓系白血病(AML)的临床疗效并评价该方案的不良反应。方法:选择21例难治/复发AML,应用CAT方案治疗32个疗程。结果:2例在骨髓抑制期死于感染性休克,可评价疗效19例,CR率为42.1%(8/19),PR率为21.1%(4/19),总有效率为63.16%。第1个诱导治疗结束后的第7～14天骨髓原始幼稚细胞下降比例>50%是影响难治复发患者总生存的一个有意义的指标。2例CR患者进行了异基因骨髓移植。主要不良反应为骨髓抑制。结论:CAT方案为难治/复发性AML患者的一个有效且毒性可耐受的治疗方案。缓解后尽早进行异基因骨髓移植可能改善预后。Objective：To observe the effects and side-effects of cyclophophamid,cytarabine,topotecan（CAT） combination regimen for the treatment of refractory acute myeloid leukemia（AML）. Method：Twenty-one patients with refractory AML were treated with CAT chemotherapy and the total courses were 32. Result：Two patients died of sepsis,8 patients achieved complete remission（CR）,4 patients achieved partial remission.The total response rate was 63.16%（12/19 cases）.Two out of 8 patients achieving CR accepted allogeneic bone marrow transplantation.Whether the reduction of blast cells at 7-14 days after the termination of first induction treatment reached more than 50% can be taken as a significant index to estimate the survival of the refractory AML.The major side-effect of CAT regimen was bone marrow suppression. Conclusion：CAT regimen may be an effective and tolerable choice for refractory acute leukemia patients.The patients achieving CR should receive allogeneic bone marrow transplantation as early as possible.

关 键 词：白血病 髓系 急性 难治 复发 拓扑替康 化疗 

分 类 号：R733.71[医药卫生—肿瘤]