大剂量阿糖胞苷治疗急性髓系白血病的疗效及不良反应  

Efficacy and Adverse Reactions of High-dose Cytarabine in the Treatment of Acute Myeloid Leukemia

作　　者：郑丽玲[1] 欧瑞明[1] ZHENG Li-ling OU Rui-ming(Guangdong No.2 People＇s Hospital, Guangdong Guangzhou 510317)

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《深圳中西医结合杂志》2017年第16期7-9,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨大剂量阿糖胞苷(HD–AraC)治疗急性髓系白血病(AML)的疗效及不良反应。方法:回顾性分析2012年6月至2016年6月在广东省第二人民医院血液科治疗的30例AML患者的临床资料,所有患者均采用含有标准剂量(AraC)阿糖胞苷的化疗方案进行诱导缓解治疗,完全缓解后行HD–AraC巩固治疗,分析治疗效果及不良反应。结果:30例患者均行诱导缓解治疗,达到完全缓解70%,有效率为76.67%;行HD–AraC巩固治疗21例,1年总生存率76.19%,1年无复发生存71.43%,2年总生存率61.90%,2年无复发生存57.14%,复发6例,复发率28.57%,死亡4例、死亡率19.05%,11例无复发生存至今;所有患者均出现IV度骨髓抑制,粒缺发热发生率80.95%,确切感染率61.90%,败血症率4.76%,出血率14.29%,治疗相关死亡率4.76%;胃肠道反应发生率38.06%,肝功能损害发生率19.05%,皮疹发生率9.52%,药物热发生率9.52%。结论:HD–AraC治疗AML疗效较好,可延长总生存周期及无复发生存期,减少复发率,提高生存质量,具有积极的临床意义。Objective To investigate the efficacy and adverse reactions of high-dose cytarabine in the treatment of acute myeloid leukemia. Method The clinical data of 30 patients with acute myeloid leukemia treated in our hospital from June 2012 to June 2016 were retrospectively analyzed, all patients were treated with a standard dose cytarabine chemotherapy regimen, after complete remission, high-dose cytarabine （HD-AraC） consolidation therapy, analysis of therapeutic effects and adverse reactions. Result All 30 patients received remission induction therapy, complete remission （CR） of 70 %, the effective rate （ORR） was 76.67 % Line HD-AraC consolidation therapy in 21 cases, 1 year overall survival （OS） was 76.19 %, 1 year recurrence free survival （RFS） was 71.43 %, 2 years OS was 61.90 %, 2 years RFS was 57.14 %, recurrence in 6 cases, recurrence rate was 28.57 %, 4 cases died, mortality 19.05 %, 11 cases had no recurrence; All patients had IV degree myelosuppression, heat loss rate was 80.95 %, exact infection rate was 61.90 %, sepsis rate was 4.76 %, bleeding rate was 14.29 %, treatment related mortality was 4.76 %; Incidence of gastrointestinal reaction was 38.06 %, the incidence of liver function damage was 19.05 %, percentage of rash was 9.52 %, the incidence of drug fever was 9.52 %. Conclusion High dose cytarabine in the treatment of acute myeloid leukemia has good curative effect, can prolong the overall survival period and recurrence free survival, reduce the recurrence rate, improve the quality of life, has a positive clinical significance.

关 键 词：急性髓系白血病 大剂量阿糖胞苷 巩固治疗 

分 类 号：R733.71[医药卫生—肿瘤]