伊达比星加中剂量阿糖胞苷强化疗对急性髓系白血病预后的影响  

Effect of idarubicin combined with medium-dose arabinoside in intensive chemotherapy on the prognosis of acute myeloid leukemia

作　　者：郭智[1] 陈惠仁[1] 楼金星[1] 刘晓东[1] 陈鹏[1] 何学鹏[1] 

机构地区：[1]北京军区总医院血液科,100700

出　　处：《白血病．淋巴瘤》2016年第7期409-412,共4页Journal of Leukemia & Lymphoma

基　　金：北京市首都临床特色课题（Z151100004015218）

摘　　要：目的：观察伊达比星加中剂量阿糖胞苷强化疗治疗急性髓系白血病（AML）的疗效和安全性。方法以北京军区总医院血液科2010年1月至2015年1月应用中剂量阿糖胞苷（2 g／m2，1次／12 h，第1天至第3天）联合伊达比星（12 mg／m2第1天）强化巩固治疗的50例诱导化疗缓解的 AML 患者为试验组，选择同期单药阿糖胞苷（2 g／m2，1次／12 h，第1天至第3天）治疗的50例患者为对照组。两组患者均序贯治疗6个疗程，试验组男性28例，女性22例，平均年龄27.6岁（18～52岁），原发病包括M1型3例，M2型27例，M4型8例，M5型12例；对照组男性30例，女性20例，平均年龄26.8岁（16～50岁），原发病包括 M1型2例，M2型30例，M4型8例，M5型10例。观察两组患者化疗并发症和无病生存等情况。结果随访至2015年6月，试验组1例死于肺部感染，2例死于感染性休克；对照组3例死于肺部感染，1例死于感染性休克。试验组和对照组患者治疗相关死亡率分别为6%（3／50）、8%（4／50）（P＞0.05），复发率分别为32%（16／50）、52%（26／50）（P＜0.05），无病生存率分别为62%（31／50）、40%（20／50）（P＜0.05）。结论伊达比星加中剂量阿糖胞苷强化疗治疗 AML 与单药阿糖胞苷相比复发率降低，无病生存率显著提高，且治疗相关死亡未增加，值得临床进一步应用。Objective To explore the efficacy and feasibility of idarubicin combined with medium-dose arabinoside in intensive chemotherapy for acute myeloid leukemia （AML）. Methods Fifty remittent patients with induced chemotherapy who underwent the intensive consolidation therapy with medium-dose arabinoside from January 2010 to January 2015 in hematology department of General Hospital of Beijing Military Area were considered as the treatment group. The single arabinoside （2 g/m 2, 1/12 h, d1-3） treatment for 50 cases in the same period were considered as the control group. Two groups were performed with 6 courses sequential. There were 28 males, 22 females in the treatment group, and average age was 27.6 years （18-52 years）, with 3 cases of M 1, 27 cases of M2, 8 cases of M4, 12 cases of M5. In the control group, there were 30 males, 20 females, and average age was 26.8 years （16-50 years）, with 2 cases of M1, 30 cases of M2, 8 cases of M4, 10 cases of M5. Then the complications and disease-free survival of two groups were observed respectively. Results Follow-up was done until June 2015. In the treatment group, 1 case died of pulmonary infection, 2 cases died of septic shock and 3 cases died of pulmonary infection, 1 case died of septic shock in the control group. The treatment related mortality of both groups were 6 % （3/50）, 8 % （4/50）, the related relapse rates were 32 % （16/50）, 52 % （26/50）, the disease-free survival rates were 62 % （31/50）, 40 % （20/50） respectively in two groups. Conclusion Compared with the single arabinoside, the intensive consolidation therapy with medium-dose arabinoside and idarubicin for the treatment of AML has gained lower relapse rate and the related mortality, and the DFS rate has been improved significantly, which need further clinical application.

关 键 词：白血病 髓样 急性 伊达比星 阿糖胞苷 强化巩固治疗 

分 类 号：R733.71[医药卫生—肿瘤]