协和医院1983年至1999年急性白血病初治诱导化疗分析  

Analysis of initial inducing chemotherapy for patients with acute leukemia in Peking union medical college hospital from 1983 to 1999

作　　者：王毓洲[1] 隋雪梅[1] 武永吉[1] 沈悌[1] 张之南[1] 

机构地区：[1]中国协和医科大学北京协和医院血液科,100730

出　　处：《北京医学》2001年第4期211-213,共3页Beijing Medical Journal

摘　　要：目的　通过总结我院 17年来初治急性白血病诱导治疗结果 ,了解目前诱导治疗现状。方法　采用回顾性分析方法 ,查阅 17年来我院所有住院的急性初治白血病病例共 34 7例 ,对其诱导化疗方案、治疗效果及毒性反应等进行统计分析。结果　采用 DA及 HOAP方案治疗非 M3 的 AML患者 ,CR率分别为 5 7.1%及 5 9.5 % ,两者并无显著性差异。而应用 HOAP治疗 AML - M3 患者 ,CR率仅为 14.2 % ,应用 ATRA诱导缓解后加 DA方案治疗 ,CR率达到 77.3%。 VEAGP及 VDL P治疗 AL L的 CR率分别为 62 .5 %及 5 9.1%。初治死亡患者中 ,颅内出血占 40 % (30 / 75 ) ,各种感染占 37.3% (2 8/ 75 )。结论　除 M3 患者外 ,不同诱导化疗方案治疗急性白血病的 CR率并无显著性差异。颅内出血、感染因素为初治诱导化疗常见死亡原因 ,且并未逐年减少。Objective To learn the situation in initial inducing chemotherapy for acute leukemia,and report the outcome of patients managed in our hospital.Methods Three hundred and forty seven patients with newly diagnosed acute leukemia were included and treatment efficacy was assessed using the retrospective investigation from 1983 to 1999.Results AML(except APL)patients treated with the regimen of DA and HOAP got 57.1% and 59.5% CR rate respectively.CR rates of ALL patients treated with VEAGP and VDLP were 62.5% and 59.1% respectively.APL patients treated with DA after ATRA inducing therapy got 77.3% CR rate.The mortality of initial treatments was 21.9%.Main causes of death were intracranial hemorrhage (40.0%,30/75) and infections (37.3%,28/75).Conclusions The treatment efficacy and mortality of APL were improved significantly since ARTR got involved in 1987.No improvement were achieved in the efficacy and mortality of other acute leukemia at initial chemotherapy in the past 17 years.Intracranial hemorrhage and infection remain the leading cause of death in initial treatments.

关 键 词：急性白血病 化疗 诱导治疗 治疗 协和医院 药物疗法 DA方案 HOAP方案 

分 类 号：R733.71[医药卫生—肿瘤]