三氧化二砷辅助治疗难治或复发急髓白血病的疗效观察  

Effect of refractory or relapsed acute myeloid leukemia treated by arsenic trioxide

作　　者：陈涛[1] 姚亚洲[1] 郑引索 罗晓辉[2] 

机构地区：[1]宝鸡市中心医院血液内科,陕西宝鸡721008 [2]宝鸡市中心医院泌尿外科,陕西宝鸡721008

出　　处：《现代肿瘤医学》2015年第10期1454-1455,共2页Journal of Modern Oncology

摘　　要：目的:研究三氧化二砷(As2O3)联合小剂量高三尖杉酯碱(homoharringtonine,HHT)、阿糖胞苷(Ara-c)治疗难治或复发性急性髓细胞白血病(relapsed acute myeloid leukemia,RAML)的疗效及不良反应。方法:难治或复发性急性髓细胞白血病患者180例随机分成两组:研究组94例,方案:三氧化二砷10mg/日,d1-5、d8-12静脉滴注,高三尖杉酯碱1mg/日,d1-14静脉滴注,阿糖胞苷25mg,皮下注射2次/日,d1-14。对照组86例,给予标准剂量HA方案:用药剂量疗程同前,不加As2O3。结果:研究组68例获得完全缓解(CR),CR率72.3%(68/94),13例获得部分缓解(PR),总有效率(ORR)86.2%(81/94)。对照组CR率54.7%(47/86),9例PR,总有效率65.1%。两组比较研究组完全缓解率、部分缓解率以及总有效率均优于对照组(P<0.05),不良反应发生率研究组与对照组无显著差异(P>0.05)。结论:小剂量阿糖胞苷方案治疗难治复发性AML的疗效比标准剂量HA方案疗效优越,化疗相关不良反应无显著差异。Objective：To study the effect and adverse reaction of arsenic trioxide （As203） combined with small dose of homoharringtonine （HHT）, cytarabine （Ara -c） in treatment of refractory and relapsed acute myeloid leukemia （RAML）. Method：All 180 patients of refractory and relapsed acute myeloid leukemia patients were randomly divided into two groups ：94 cases in study group, the scheme：arsenic trioxide 10mg/day in d1 -5, d8- 12 intravenous drip; Homeharringtonine ling/days, d1 - 14 intravenous drip, Ara 25rag, subcutaneous injection of 2/days, d1-14.86 cases in control group, treated with a standard dose HA regimen：As previous without As2O3. Results：In study group 68 patients got complete remission（ CR）, the CR rate was 72.3% （68/94）, 13 cases partial remission（ PR）, the total efficiency was 86.2%. CR in control group was 54.7% （47/86） ,9 cases were PR,the total efficiency was 65.1%. The rate of complete remission, partial remission rate and total effective rate in study group was better than the control group （P 〈 0.05）, the incidence of adverse reactions in study group and the control group had no significant difference （ P 〉 0.05 ）. Conclusion： The curative effect of small dose cytarabine in treatment of refractory and relapsed AML is superior than the effect of a standard dose of HA scheme, there was no significant differences in adverse reaction of chemotherapy.

关 键 词：三氧化二砷(As2O3) 高三尖杉酯碱(HHT) 阿糖胞苷(Ara-c) 难治或复发性急性髓细胞白血病(RAML) 

分 类 号：R733[医药卫生—肿瘤]