伴高白细胞血症难治性急性髓系白血病的临床研究  

Clinical study of refractory acute myeloid leukemia with hyperleukocytosis

作　　者：周英[1] 关军[1] 程平[1] 吴思静 程辉[1] ZHOU Ying;GUAN Jun;CHENG Ping;WU Sijing;CHENG Hui(Department of Hematology , Wuhan First Hospital, Hubei 430022, China)

机构地区：[1]武汉市第一医院血液内科

出　　处：《中国输血杂志》2019年第6期553-556,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨白细胞分离术联合含地西他滨方案治疗伴高白细胞血症的难治性急性髓系白血病(refractory acute myeloid leukemia,RAML)的安全性和有效性。方法应用白细胞分离术后行地西他滨联合CAG方案治疗10名伴高白细胞血症的RAML患者,并观察其疗效和不良反应。结果经治疗后10名患者有5名达形态学完全缓解(complete remission,CR),CR率达50%,4名部分缓解(partial remission,PR),1名治疗失败,总有效率(overall remission rate,ORR)为90%。10名患者行白细胞分离术后白细胞瘀滞综合征均改善缓解,化疗过程中未新发肿瘤溶解综合征,均未发生早期死亡和治疗相关死亡。10名患者的感染和出血,均得到有效控制,均未发生严重消化系统不良反应。结论白细胞分离术联合含地西他滨方案可以有效治疗伴高白细胞血症的RAML,且早期病死率低。Objective To explore the safety and efficacy of leukapheresis combined with decitabine in the treatment of refractory acute myeloid leukemia(RAML) with hyperleukocytosis. Methods 10 cases of RAML with hyperleukocytosis were treated with decitabine combined with CAG after the operation of leukapheresis, and the efficacy and adverse reactions were observed.Results After treatment, 5 patients achieved complete remission(CR), with the CR rate of 50%, 4 patients achieved partial remission(PR), 1 had treatment failure, and the overall remission(ORR) rate was 90%. The leukostasis relieved after leukapheresis, and no tumor lysis syndrome was found again in the course of chemotherapy. No early death or treatment-related death occurred. All patients developed infection and hemorrhage, which were effectively controlled without serious gastrointestinal reactions. Conclusion The regimen of decitabine combined with leukapheresi is an effective treatment for RAML patients with hyperleukocytosis,leading to lower early mortality.

关 键 词：高白细胞血症 难治性急性髓系白血病 白细胞分离术 地西他滨 

分 类 号：R557.1[医药卫生—血液循环系统疾病] R730.53[医药卫生—内科学]