IA方案和DA方案诱导缓解老年初治急性髓系白血病的临床疗效观察  

Clinical Curative Efficacy of Inducing Remission for the Newly Diagnosed Aged AML Patients by Chemotherapy with IA and DA Regimens

作　　者：田冬华[1] 甘思林[2] 邢海洲[2] 刘延方[2] 谢新生[2] 孙慧[2] 

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450007 [2]郑州大学第一附属医院血液科,河南郑州450052

出　　处：《中国实验血液学杂志》2014年第5期1282-1285,共4页Journal of Experimental Hematology

摘　　要：本研究旨在比较去甲氧柔红霉素联合阿糖胞苷(IA)和柔红霉素联合阿糖胞苷(DA)方案诱导缓解治疗老年初治急性髓系白血病(AML)的临床疗效及不良反应。回顾性分析了60例老年初治AML(M3除外)患者应用IA方案或DA方案诱导缓解治疗的临床资料。在IA组22例中男8例,女14例,中位年龄66岁;在DA组38例中男20例,女18例,中位年龄64岁。临床疗效观察指标为化疗1个疗程后的完全缓解率、总有效率和不良反应。结果表明:IA组14例患者达完全缓解(CR),CR率为63.63%,DA组12例达CR,CR率为31.58%,两组差异有统计学意义(P<0.05)。IA组与DA组患者的总有效率分别为63.63%和36.84%,两组差异有统计学意义(P<0.05)。两组化疗方案的不良反应主要包括血液学不良反应及非血液学不良反应,两组血液学不良反应主要为骨髓抑制,两组差别无统计学意义(P>0.05);非血液学不良反应差别也无统计学意义(P>0.05)。结论:对于初治老年AML患者,IA组的1个疗程缓解率和总有效率较DA组高(P<0.05),且IA组的不良反应发生并无明显增加。This study was aimed to explore the clinical efficacy and toxicity of idarubicin（IA regimen） and daunorubicin combined with cytarabine （DA regimen） for treating aged patients with AML as induction chemotherapy.The clinical data of 60 newly diagnosed AML aged patients treated with IA or DA regimen were analyzed retrospectively.IA regimen group included 22 patients （8 male and 14 females with median age of 66 yrs）,while the DA regimen group included 38 patients （20 males and 18 females with median age of 64 yrs）.The complete remission rate,total effective rate and adverse effects after one chemotherapy course were compared.The results showed that the CR rate in IA regimen group was 63.63%,which was significantly higer than that in DA regimen group （31.58%）（P 〈 0.05）.The total effective rate was 63.63% and 36.84% respectively in IA and DA regimen groups,there was significant difference between the two groups （P 〈 0.05）.Both the hematological and non-hematological adverse effects were observed and no difference was found in the two regimen groups,neither in myelosupression （P 〉 0.05）,the major hematological adverse effects,nor in non-hematological adverse effects （P 〉 0.05）.It is concluded that for aged AML patients,IA regimen can achieve a higher CR rate and higher total effective rate than that in DA regimen without increase of adverse effects after one induction chemotherapy course.

关 键 词：急性髓系白血病 老年患者 去甲氧柔红霉素 阿糖胞苷 诱导化疗 

分 类 号：R733.71[医药卫生—肿瘤]