改良VDLP方案治疗初治老年急性淋巴细胞白血病的疗效分析  

Efficacy of modified VDLP regimen in the treatment of newly diagnosed acute lymphoblastic leukemia in the elderly

作　　者：代利霞 蔡冰冰 涂小琼 DAI Lixia;CAI Bingbing;TU Xiaoqiong(Department of Hematology,Suizhou Hospital Affiliated to Hubei Medical College,Suizhou 441300,China)

机构地区：[1]湖北医药学院附属随州医院血液内科,湖北随州441300

出　　处：《临床肿瘤学杂志》2018年第8期725-729,共5页Chinese Clinical Oncology

摘　　要：目的探讨改良VDLP(长春新碱+柔红霉素+左旋门冬酰胺酶+强的松)方案治疗初治老年急性淋巴细胞白血病(ALL)的临床疗效和安全性。方法收集本院2013年1月至2015年3月的初治老年ALL患者82例,采用随机数字表法分别接受传统VDLP方案(对照组,n=41)或改良VDLP方案(观察组,n=41)治疗。两方案均为28天1个周期,2个周期后评价疗效并以NCI-CTCAE 4.0版评价评价毒副反应,根据随访资料比较两组的中位生存期(OS)和无病生存期(DFS)。结果全组82例患者均可评价疗效;观察组的完全缓解率、总有效率和疾病控制率分别为61.0%、80.5%和97.6%,与对照组的63.4%、85.4%和100.0%比较,差异无统计学意义(P>0.05);观察组25例达完全缓解(CR)的时间为(23.34±6.64)d,对照组26例达CR的时间为(21.45±6.02)d,差异无统计学意义(P>0.05)。观察组和对照组的中位OS分别为13.0个月和12.0个月,中位DFS分别为7.5个月和8.3个月,差异无统计学意义(P>0.05)。观察组的骨髓抑制程度显著轻于对照组,且观察组的骨髓抑制恢复时间为(9.43±1.81)d,较对照组的(12.39±2.52)d,差异有统计学意义(P<0.05),两组消化道反应、脱发、口腔溃疡、血象异常、心脏毒性、肝脏毒性和肾脏毒性发生率的差异无统计学意义(P>0.05)。结论改良VDLP方案治疗初治老年ALL可获得与传统VDLP相当的近期疗效,但骨髓抑制更轻且恢复更快,更适合初治老年ALL患者的诱导化疗。Objective To investigate the clinical efficacy and safety of modified VDLP （vincristine＋daunorubicin＋L-aspara-ginase＋prednisone） regimen in the initial treatment of elderly patients with acute lymphoblastic leukemia （ALL）. Methods FromJanuary 2013 to March 2015, 82 cases of elderly patients with newly diagnosed ALL in our hospital were randomly divided into observa-tion group and control group, with 41 cases in each group. The observation group was treated with modified VDLP regimen and the con-trol group was treated with traditional VDLP regimen with 28 days a cycle. After 2 cycles, the efficacy was evaluated and the sideeffects were evaluated with the NCI-CTCAE 4 version. The median overall survival （OS） and disease-free survival （DFS） were com-pared in both groups according to the follow-up data. Results All the 82 patients were evaluable for response. The complete remissionrate, response rate and disease control rate of the observation group were 61. 0%, 80. 5% and 97. 6%, similar with 63. 4%, 85. 4%and 100% of the control group （P〉0. 05）. The time to reach complete remission in the observation group was （23. 34±6. 64）d, simi-lar with （21. 45±6. 02）d of the control group （P〈0. 05）. The median OS of observation group and control group were 13. 0 months and12. 0 months, and the median DFS was 7. 5 months and 8. 3 months （P〉0. 05）. The incidence of bone marrow suppression in the ob-servation group was significantly lighter than that in the control group, and the recovery time of bone marrow suppression in the observa-tion group was （9. 43±1. 81）d, similar with （12. 39±2. 52）d of the control group, and the difference was statistically significant （P〈0. 05）. No significant difference was observed on alimentary tract reaction, alopecia, oral ulcers, hemogram abnormalities, cardiac tox-icity, hepatotoxicity and nephrotoxicity between both groups （P〉0. 05）. Conclusion The modified VDLP regimen for the treatment ofALL in the first treatment of the

关 键 词：急性淋巴细胞白血病 老年患者 初治 改良VDLP方案 

分 类 号：R733.7[医药卫生—肿瘤]