阿糖胞苷分别联合柔红霉素和去甲氧柔红霉素诱导治疗初治急性髓系白血病临床效果比较  

Inducing therapy of cytarabine combined with daunorubicin or idarubicin for the newly diagnosed acute myeloid leukemia：comparison of clinical efficacy

作　　者：黄达永[1] 魏娜[1] 付丽[1] 王晶石[1] 沈晶[1] 吴林[1] 王旖旎[1] 杨凌志[1] 崔华[1] 王昭[1] 

机构地区：[1]首都医科大学附属北京友谊医院血液科,100050

出　　处：《白血病．淋巴瘤》2016年第10期592-594,共3页Journal of Leukemia & Lymphoma

摘　　要：目的：比较柔红霉素联合阿糖胞苷（DA）方案和去甲氧柔红霉素联合阿糖胞苷（IA）方案诱导治疗初治急性髓系白血病（AML）的临床疗效及患者不良反应。方法回顾性分析应用 DA 方案或 IA方案诱导缓解治疗的84例初治 AML（除外 M3）患者临床资料。 DA 组32例，其中男性17例，女性15例，中位年龄46岁；IA 组52例，其中男性29例，女性23例，中位年龄49岁。疗效指标为化疗1个疗程后的完全缓解（CR）率、总有效率和不良反应发生率。结果 DA 组 CR 率为65.6％（21／32），总有效率为75.0％（24／32）；IA 组 CR 率为71.2％（31／52），总有效率为80.8％（42／52），两组 CR 率和总有效率差异均无统计学意义（均 P＞0.05）。两组患者中位生存时间和5年生存率差异均无统计学意义（DA 与IA 组中位生存时间：16.8个月比24.9个月，5年生存率：26%比44%，均 P＞0.05）。两组不良反应包括血液学（主要为骨髓抑制）和非血液学不良反应，两组间各不良反应发生率差异均无统计学意义（均 P＞0.05）。结论对于初治 AML 患者，DA 方案诱导治疗1个疗程的缓解率和总有效率与 IA 方案相当，且两方案的不良反应发生率无明显不同。Objective To explore the clinical effect and toxicity of daunorubicin combined with cytarabine （DA regimen） and idarubicin combined with cytarabine （IA regimen） for the treatment of patients with acute myeloid leukemia （AML） as induction chemotherapy. Methods The clinical data of 84 newly diagnosed AML patients （except M3） treated with DA or IA regimen were analyzed retrospectively. DA regimen group included 32 patients （17 males and 15 females with median age of 46 years）, while IA regimen group included 52 patients （29 males and 23 females with media age of 49 years）. Efficacy index was complete remission （CR）, total efficiency and adverse reactions after one course of chemotherapy rate. Results In DA regimen group,the CR rate was 65.6 %（21/32）, and the total efficiency rate was 75.0 %（24/32）, while in IA regimen group, the CR rate was 71.2 %（31/52）, and the total efficiency rate was 80.8 %（42/52）, respectively, but, the differences of media survival and 5-year survival rate were not statistically significant （16.8 months vs. 24.9 months, 26 % vs. 44 %, both P〉0.05）. The main side effect in the two groups included hematologic （bone marrow suppression） and non-hematologic adverse reactions, with no significant difference between the two groups （all P〉0.05）. Conclusion For newly diagnosed AML patients, remission rate and total efficiency of DA regimen are same as IA regimen after one course treatment, and adverse events between the two regimens do not differ significantly.

关 键 词：白血病 髓样 急性 柔红霉素 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]