地西他滨联合减量FLAG方案治疗老年高危急性髓系白血病患者的临床疗效观察  

Clinical Effectiveness of Decitabine Combined with Reduced FLAG Regimen in the Treatment of Senile Patients with High-Risk Acute Myeloid Leukemia

作　　者：齐瑶 赵明峰[1] 肖霞[1] 李青[1] 蒋怡丽 孙瑞 QI Yao;ZHAO Ming-Feng;XIAO Xia;LI Qing;JIANG Yi-Li;SUN Rui(Department of Hematology,Tianjin First Central Hospital,The First Central Clinical College of Tianjin Medical University,Tianjin 300192,China)

机构地区：[1]天津医科大学第一中心临床学院,天津市第一中心医院血液科,天津300192

出　　处：《中国实验血液学杂志》2020年第5期1440-1444,共5页Journal of Experimental Hematology

基　　金：天津市自然科学基金重点项目(17JCZDJC35800);天津市卫生行业重点攻关项目(16KG110)。

摘　　要：目的:探究地西他滨联合减量FLAG方案治疗老年高危AML患者的疗效及不良反应。方法:对12例老年高危AML患者采用地西他滨联合减量FLAG方案(地西他滨20 mg/m^2,qd,d 1-5;氟达拉滨50 mg/d,d 3-6;阿糖胞苷1 g/m^2,qd,d 3-6;G-CSF 300μg,qd,自d 2起至中性粒细胞达最低值后恢复>1.0×10^9/L)进行诱导化疗,观察临床疗效及其不良反应。结果:12例患者经1个疗程化疗后,9例获得完全缓解,2例获得部分缓解,1例病情稳定,总有效率为92%。中位随访时间7.4(3-12)个月,中位生存期6.4个月。化疗的不良反应主要有骨髓抑制和粒细胞缺乏所致的感染,无严重的非血液学不良反应,无治疗相关死亡。结论:地西他滨联合减量FLAG方案作为诱导缓解方案对老年高危AML疗效确切,能显著提高CR率并降低不良反应,可作为老年高危AML首选诱导缓解方案之一。Objective:To explore the efficacy and adverse reactions of decitabine combined with reduction FLAG regimen on the senile patients with high-risk AML.Methods:12 senile patients with high-risk AML received decitabine combined with reduced FLAG regimen(decitabine 20 mg/m^2,intravenous drip,qd,d 1-5;fludarabine 30 mg/m^2,intravenous drip lasts 30 min,qd,d 3-6;Ara-C 1 g/m^2,intravenous drip,qd,d 3-6;and G-CSF 300μg/d,subcutaneous injection,d 2 to neutrophils reached the lowest return to>1.0×10^9/L)in our study.The efficacy and adverse reactions of this regimen were analyzed.Results:9 patients achieved complete remission(CR)after one course of decitabine combined with reduced FLAG regimen,2 patients achieved partial remission(PR)and 1 patient reached a stable disease(SD).The overall response rate was 92%.The median follow-up period was 7.4 months ranged from 3 to 12 months.The median survival time for all patients was 6.4 months.The main treatment-related toxicities were myelosuppression and infection due to neutropenia.Severe non-hematologic toxicities were not observed in these patients,and there was no treatment-related mortality.Conclusion:Decitabine combined with reduced FLAG regimen has a definite clinical efficacy in the treatment of senile patients with high-risk AML.This regimen,as induction remission regimen,can effectively improve the CR rate and reduce the adverse reactions.Therefore,it may be used as one of the preferred induction remission regimen to treat the senile patients with high-risk AML.

关 键 词：高危急性髓系白血病 老年 地西他滨 FLAG方案 

分 类 号：R733.71[医药卫生—肿瘤]