IAG方案诱导治疗急性髓系白血病的临床效果观察  

Efficacy observation of IAG regimen for acute myelogenous leukemia

作　　者：杜丰[1] 薛胜利[2] 龚蔚[1] 陶涛[1] 徐静[1] 叶春梅[1] 付铮铮[2] 吴德沛[2] 

机构地区：[1]苏州大学附属第一医院娄葑分院血液科,215000 [2]苏州大学附属第一医院血液科江苏省血液研究所卫生部血栓与止血重点实验室

出　　处：《白血病．淋巴瘤》2014年第1期41-44,共4页Journal of Leukemia & Lymphoma

摘　　要：目的 探讨小剂量阿糖胞苷和去甲氧柔红霉素联合粒细胞集落刺激因子（G-CSF）组成的IAG预激方案治疗急性髓系白血病（AML）的疗效和患者不良反应.方法 回顾性分析25例AML患者在采用IAG预激方案诱导治疗1个疗程后的临床效果.IAG方案：去甲氧柔红霉素5 mg,静脉滴注,隔天1次,共7～8次;阿糖胞苷每12 h 10 mg/m2,皮下注射,第1天至第14天;G-CSF每天200 μg/m2,皮下注射,用药前一天至第14天.结果 化疗后总有效率80.0％（20/25）,完全缓解（CR）率60.0％（15/25）.初诊17例患者中,9例CR,4例部分缓解（PR）;复发难治患者8例中,6例CR,1例PR.骨髓增生异常综合征（MDS）转化的AML7例中,5例CR,2例PR;≥50岁的11例患者中,8例CR,1例PR.化疗的不良反应主要为骨髓抑制、胃肠道反应、肝肾功能损害;无早期死亡病例.结论 IAG预激方案是治疗AML（包括高危AML）的较有效、安全的方案.Objective To assess the therapeutic effect and side effects of IAG priming regimen for the treatment of acute myelogenous leukemia （AML）.Methods A retrospective study of 25 AML patients receiving one course of IAG regimen treatment was performed.IAG priming regimen comprised low-dose cytarabine （10 mg/m2 subcutaneously every 12 h on days 1-14）,idarubicin （5mg intravenously every other day for 7-8 times） and granulocyte colony-stimulating factor （200 mg/m2 subcutaneously daily on days 1-14）.Results After one course induction therapy of IAG regimen,an overall response rate of 80 ％ （20/25） and complete remission rate of 60 ％ （15/25） were achieved.Among the initial diagnosed 17 AML patients,9 got CR,4 got PR.Among the 8 relapsed or refractory patients,6 got CR,1 got PR.Among the 7 AML patients transformed from myelodysplastic syndrome,5 got CR,2 got PR.Among the 11 aged patients （≥ 50 years old）,8 achieved CR,1 achieved PR.The main side effects consisted of myelosuppression,gastrointestinal tract reaction and mild or moderate liver or renal impairment.No death was recorded.Conclusion IAG priming regimen is an effective and less toxic treatment protocol for AML patients,including those with high-risk features.

关 键 词：白血病 髓样 急性 IAG预激方案 去甲氧柔红霉素 阿糖胞苷 粒细胞集落刺激因子 

分 类 号：R733.71[医药卫生—肿瘤]