氟达拉滨联合中剂量阿糖胞苷用于急性髓系白血病治疗的疗效及不良反应  

Efficacy and side effects of fludarabine combined with medium dose cytarabine in the treatment of acute myeloid leukemia

作　　者：孙善芳[1] 袁红建[1] 邓银芬[1] 潘怀富[1] Sun Shanfang;Yuan Hongjian;Deng Yinfen;Pan Huaifu(Department of Hematology, Taizhou Second People' s Hospital, Taizhou, Jiangsu, 225500, China)

机构地区：[1]泰州市第二人民医院血液科,江苏泰州225500

出　　处：《当代医学》2018年第35期33-35,共3页Contemporary Medicine

摘　　要：目的探讨氟达拉滨联合中剂量阿糖胞苷用于急性髓系白血病治疗的疗效及不良反应。方法选取本院2010年9月至2016年10月收治的36例急性髓系白血病(AML)患者为研究对象,两组患者均经1～2个疗程诱导缓解,观察组再行氟达拉滨联合中剂量阿糖胞苷治疗,对照组再行阿糖胞苷治疗。随访1年,对比两组患者化疗后临床疗效和不良反应发生情况。结果观察组患者DOR和中位OS分别为12个月和24个月,对照组分别为6个月、16个月,观察组均显著高于对照组,差异有统计学意义(P<0.05)。随访1年后发现,观察组复发率(44.44%)、死亡率(27.78%)显著低于对照组复发率(61.11%)、死亡率(44.44%),组间差异具有统计学意义(P<0.05)。观察组有16例(88.89%)患者出现4度骨髓抑制,对照组有10例(55.56%)患者出现4度骨髓抑制,两组患者4度骨髓抑制发生率对比差异有统计学意义(c2=27.688 5,P<0.05)。结论 AML患者在诱导缓解化疗方案诱导完全缓解(CR)后,采用氟达拉滨联合中剂量阿糖胞苷方案治疗可以明显降低患者复发率、死亡率以及非血液学毒性反应发生率,骨髓抑制明显,但不会提高感染率,值得临床推广。Objective To investigate the efficacy and side effects of fludarabine combined with medium dose cytarabine in the treatment of acute myeloid leukemia. Methods Thirty-six patients with acute myeloid leukemia(AML) admitted from our hospital(September 2010 to October 2016)were selected as study subjects. Patients in both groups were treated with 1-2 courses of induction of remission. The observation group was treated with fluoride Darabine combined with medium dose of cytarabine treatment, control group and then cytarabine treatment. Followed up for 1 year,compared two groups of patients after chemotherapy clinical efficacy and adverse reactions. Results The DOR and median OS in the observation group were 12 months and 24 months, respectively. The control group was 6 months and 16 months, the observation group was significantly higher than the control group, the difference was statistically significant(P<0.05). After 1 years of follow-up, it was found that the recurrence rate(44.44%) and mortality rate(27.78%) in the observation group were significantly lower than those in the control group(61.11%), and the mortality rate(44.44%). The difference between the two groups was statistically significant(P<0.05), as shown in table 2. In the observation group, 16 cases(88.89%) had 4 degree of myelosuppression, and 10 cases(55.56%) in the control group had 4 degree of myelosuppression. There was a statistically significant difference in the incidence of 4 degrees of myelosuppression between the two groups(χ^2=27.688 5, P<0.05). Conclusion AML patients treated with fludarabine combined with medium dose of cytarabine can significantly reduce the incidence of recurrence, mortality and non-hematologic toxic reactions in patients with AML after induction of complete remission(CR) by induction chemotherapy, bone marrow Obvious inhibition,but will not increase the infection rate, it is worth clinical promotion.

关 键 词：氟达拉滨 阿糖胞苷 急性髓系白血病 疗效 不良反应 

分 类 号：R733.71[医药卫生—肿瘤]