小剂量MA与CAG方案诱导治疗老年急性髓系白血病的效果比较  

Comparison of therapuetic efficacies of MA and CAG induction chemotherapy regimen in elderly acute myelogenous leukemia patients

作　　者：张春静[1] 姜中兴[1] 田文亮[1] 郭荣[1] 李英梅[1] 李丽[1] 

机构地区：[1]郑州大学第一附属医院血液科,河南郑州450052

出　　处：《河南医学研究》2017年第17期3083-3087,共5页Henan Medical Research

摘　　要：目的对比分析采用小剂量米托蒽醌、阿糖胞苷(MA)与阿克拉霉素、阿糖胞苷、G-CSF(CAG)方案诱导治疗老年急性髓系白血病(AML)患者的效果。方法回顾性分析2012年5月1日至2016年5月1日郑州大学第一附属医院连续收治的100例年龄≥60岁确诊AML患者的临床资料。其中,NPM1+FLT3-ITD-者占10%(10/100),46例采用小剂量MA方案诱导化疗,54例采用CAG方案诱导化疗,诱导化疗后评价效果。与CAG组相比,小剂量MA化疗组患者发病时WBC显著升高(P=0.005),FLT3-ITD+患者比例显著升高(P=0.006)。结果 5例(5%)早期死亡,70例(70.0%)患者在接受第1个诱导化疗后获得缓解,54例(54.0%)获得完全缓解(CR),16例(16.0%)获得部分缓解(PR),其中46例应用小剂量MA方案化疗的患者中,24(52.2%)例达到CR,6例(6.0%)达到PR,总有效率为65.2%。54例老年AML应用CAG方案诱导化疗,30例(55.6%)例达到CR,10例(18.2%)达到PR,总有效率为71.4%,两组方案的CR、总CR差异无统计学意义(P=0.735,0.335)。两组化疗不良反应差异无统计学意义(P均>0.05)。结论老年AML患者应用小剂量MA与CAG诱导化疗治疗效果相似,且未增加患者的不良反应,为白细胞增高患者的另一选择。Objective To analyze the difference of therapuetic efficacies of MA and CAG induction chemotherapy regimen in elderly acute myelogenous leukemia （AML） patients. Methods From May of 2012 to May of 2016, the clinical data of 100 con- secutive hospitalized 60 - plus - year - old AML patients were retrospectively analyzed. NPM1 ＋ FLT3 - ITD - accounted for 10 ca- ses （ 10% ）, 46 patients received MA regimen and 54 patients received CAG regimen, MA group had higher WBC and FLT3 - ITD ~ positive mutations at diagnosis compared with CAG group （P = 0. 005, P = 0. 006）. Results Five patients （5%） died in early phase. Complete remission （CR） rate after the first cycle of induction chemotherapy was 54. 0% （54/100） , overall CR rate was 70. 0% （70/100）, CR rate after the first cycle of induction chemotherapy and overall CR rate were indiscriminate be- tween MA and CAG regimen. Two groups of adverse reaction of chemotherapy were indiscriminate （P 〉 0. 05 ）. Conclusion There is indiscrimination of efficacy among MA and CAG induction chemotherapy in old AML patients.

关 键 词：老年 急性髓系白血病 诱导化疗方案 

分 类 号：R733.71[医药卫生—肿瘤]