小剂量长疗程HA方案治疗不典型慢性粒细胞白血病的临床效果观察  

Clinical effect of low-dose homoharringtonine and cytarbine with long-course in treating atypical chronic myeloid leukaemia

作　　者：沈继春[1] 杨文华[3] 刘晓梅[2] 郭赟[1] 陈艳鑫[1] 岑冰[1] 

机构地区：[1]武警后勤学院附属医院血液科,天津300162 [2]武警后勤学院附属医院检验科,天津300162 [3]天津中医药大学第一附属医院血液科

出　　处：《中国综合临床》2015年第5期391-394,共4页Clinical Medicine of China

基　　金：教育部高等学校博士点专项科研基金课题（20121210110004）

摘　　要：目的探讨小剂量长疗程高三尖杉酯碱和阿糖胞苷的HA方案治疗不典型慢性粒细胞白血病（aCML）的临床效果。方法选择我院2003年lO月至2014年5月已确诊为aCML患者27例，治疗组14例给予小剂量长疗程HA方案，高三尖杉酯碱1．5mg／（m^2·d），阿糖胞苷100mg／（m^2·d）静脉滴注给药2周。对照组13例给予羟基脲1-3g/d口服，重组人干扰素α-2b3×10^6U隔日1次肌肉注射，连续4周。分析两组患者治疗前及治疗1、2、3、4周的白细胞计数（WBC）、血红蛋白（Hb）及血小板计数（PLT）的变化，治疗4周查血象和骨髓象评价两组治疗效果。结果两组患者治疗前和治疗1周的WBC、Hb、PLT及2周时Hb比较差异均无统计学意义（P均〉0．05），2周时WBC和PLT及3、4周时WBC、Hb、PLT比较差异均有统计学意义（P均〈0．05），重复测量资料的方差分析结果显示：两组WBC、Hb和PLT相比，差异均有统计学意义（F自目分别为833．16、145．59、143．11，P均〈0．05），不同时间点的差异亦有统计学意义（F自自分别为443．92、17．41、149．11，P均〈0．05），均存在交互作用（F交互分别为69．77、43．26、75．25，P均〈0．05）。治疗组14例患者中，8例完全缓鹪，2例部分缓解，4例未缓解，总有效率为71．4％（10／14）；对照组13例患者中，无一例完全缓解，2例部分缓解，11例未缓解，总有效率为15．4％（2／13），两组总有效率差异有统计学意义（x^2=11．25，P〈0．01）。结论小剂量长疗程HA方案治疗aCML的效果好，临床可操作性强，安全性好。Objective To investigate the therapeutic effect of low-dose and long-course homoharringtonine and eytarbine （ HA ） in treating atypical chronic myeloid leukaemia （ aCML ） . Methods Twenty-seven patients diagnosed atypical chronic myeloid leukaemia（aCML） from Oct. 2003 to May 2014. in the Affiliated Hospital of Logistics University of People＇s Armed Police Force were divided into treatment and control groups. Fourteen cases in the treatment group were given the chemotherapy of HA （ H ： 1.5 mg/（ m2· d）, A ： 100 mg/（m2 · d） for two weeks, and 13 cases in the control group were given the combined therapy of Hydroxycarbamide（ 1-3 g/d） and recombined human interferon α-2b（ 3x 106U by intramuscular injection every other day ） for four weeks. The haemoglobin （ Hb ） level, the numbers of white blood cell count （ WBC ） and platelet count（PLT） were measured. Moreover,the clinical effects were evaluated through measured hemogram and myelogram at 4 weeks after treatment. Results The levels of Hb, the numbers of WBC and PLT at before and 1 and 2 weeks in treatment group were as same as those in control group（ P〉0. 05 ）. While, the numbers of WBC and PLT at 2 weeks,as well as Hb and the numbers of WBC and PLT in 3 weeks,4 weeks in treatment group were significantly different from those in control group （ P 〈 0. 05 ） . Furthermore, repeated measurement ANOVA showed that the levels of WBC, Hb, PLT between two groups were significant （F between groups = 833. 16,145.59,143. 11 ;P〈0. 05） , and there were significant differences at different time（ F between groups = 443.92,17. 41,149. 11 ; P 〈0. 05 ）, meanwhile with interaction （ F across group = 69. 77, 43.26, 75.25 ; P 〈0. 05）. In treatment group, there was 8 cases were complete remission, 2 cases were partial remission and 4 cases were not released, and the total effective rate 71.4%. While in control group,there were no one was complete remission ,2 cases were partial remission and 4 cases were not r

关 键 词：不典型慢性粒细胞白血病 高三尖杉酯碱 阿糖胞苷 小剂量 长疗程 

分 类 号：R733.72[医药卫生—肿瘤]