阿柔比星联合阿糖胞苷方案与柔红霉素联合阿糖胞苷方案治疗初治急性髓细胞白血病中、老年患者的临床疗效分析  

Aclarubicin combined with cytarabine and daunorubicin combined with cytarabine regimens in treatment of middle-aged and elderly patients with untreated acute myeloid leukemia

作　　者：梁立莉[1] 谭晓虹[2] 岑洪[2] 滕炳祥[1] 熊春[1] 

机构地区：[1]广西科技大学第一附属医院肿瘤血液科,柳州545002 [2]广西医科大学附属肿瘤医院淋巴血液及儿童肿瘤科,南宁530021

出　　处：《国际输血及血液学杂志》2017年第4期289-294,共6页International Journal of Blood Transfusion and Hematology

基　　金：广西壮族自治区卫生计生委医疗卫生适宜技术研究与开发课题（S201301-02）

摘　　要：目的探讨阿柔比星联合阿糖胞苷（AA）方案与采用柔红霉素联合阿糖胞苷（DA）方案治疗初治急性髓细胞性白血病（AML）中、老年患者的临床疗效。方法选择2009年1月至2015年12月于广西科技大学第一附属医院住院的109例初治AML中、老年患者为研究对象。采用随机数字表法将其分为AA组（n=55，接受AA化疗方案）和DA组（n=54，接受DA化疗方案）。采用统计学方法比较2组患者的临床治疗效果，包括不同危险度分层患者的治疗效果，以及血液学及非血液学不良反应。结果①AA组初治AML患者的治疗总有效率为72．7％（40／55），与DA组的75．9％（41／54）比较，差异无统计学意义（x^2=0．15，P〉0．05）。②AA组和DA组高危初治AML中、老年患者治疗有效患者数分别为1例和2例。2组中、低危患者的治疗有效率比较，差异无统计学意义（P〉0．05）。③化疗后，2组初治AMI。中、老年患者的血液学不良反应比较，差异无统计学意义（P〉0．05）。④AA组初诊AML的心脏损伤发生率为1．8％（1／55），低于DA组的18．5％（10／54），2组比较，差异有统计学差异（x^2=8．38，P〈0．05）。2组其余非血液学不良反应发生率比较，差异均无统计学意义（P〉0．05）。结论AA与DA方案治疗初治AML中、老年患者的临床疗效相似，血液学不良反应类似，而AA方案在非血液学不良反应方面优于DA方案。Objective To investigate clinical efficacies of aclarubicin combined with cytarabine （AA） regimen and daunorubicin combined with cytarabine （DA） regimen in treatment of middle-aged and elderly patients with untreated acute myeioid leukemia （AML）. Methods From January 2009 to December 2015, a total of 109 patients admitted to the First Affiliated Hospital of Guangxi University of Science and Technology were enrolled in this study. According to random number table method, they were divided into AA group （n= 55） and DA group （n： 54）. The patients in AA group were treated with AA regimen, meanwhile DA group was treated with DA regimen. The clinical treatment effects （including the therapeutic effect of different risk stratified patients）, hematology and non-hematological adverse reactions were compared between two groups. Results （1） The total effective rate of treatment in AA group was 72.7% （40/55）, which was not statistically significant （x^2=0. 15,P〉0.05） compared with that of 75.9% （41/ 54） in DA group. （2） The effective number of patients with high-risk AML in AA group and DA group were 1 case and 2 cases, respectively. There were no significant differences in effective rate of patients with middle-risk and low-risk AML between two groups（P〉 0. 05）. （3） After chemotherapy, there were no significant differences in hematological adverse reactions between two groups （P〉0.05）. （4） The incidence of cardiac injury was 1.8% （1/55） in AA group, which was lower than that of DA group （18.5%, 10/54）. The difference was statistically significant （x^2 = 8.38, P〈0.05）. There was no significant difference in the other non-hematological adverse reactions between two groups （P 〉 0. 05）. Conclusions The clinical efficacy and hematological adverse reactions after treatment of AA and DA in the treatment of middle-aged and elderly patients with AML are similar, while the AA regimen is superior to the DA in the nonhematological adverse reactions.

关 键 词：抗肿瘤联合化疗方案 白血病 髓样 急性 治疗结果 中老年患者 

分 类 号：R733.71[医药卫生—肿瘤]