CAG方案与标准剂量方案对初治老年急性髓系白血病患者诱导缓解率及不良反应影响  

Effects of CAG regimen and standard dose regimen on induced remission rate and adverse reactions in newly treated elderly patients with acute myeloid

作　　者：任丽蓉 陶黎[1] 官晓红[1] 练颖 张开基 雷丽华[1] 胡谦[1] REN Lirong;TAO Li;GUAN Xiaohong;LIAN Ying;ZHANG Kaiji;LEI Lihua;HU Qian(Department of Hematology,Hospital of Integrated Traditional Chinese and Western Medicine of Chengdu, Chengdu 610000,China)

机构地区：[1]成都市中西医结合医院血液科,四川成都610000

出　　处：《西北国防医学杂志》2021年第6期511-515,共5页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨CAG方案与标准剂量方案对初治老年急性髓系白血病(acute myelogenous leukemia,AML)(其中AML-3型除外)患者诱导缓解率及不良反应的影响。方法:回顾性选取本院2015-07-01~2017-04-30共60例老年AML患者,根据诱导缓解方式,将采用CAG预激方案治疗的患者32例作为A组,将采用常规剂量DA方案的患者28例作为B组,比较两组诱导缓解率、不良反应情况。结果:A组与B组治疗有效率分别为71.88%、78.57%,差异无统计学意义(P>0.05)。两组治疗前后血红蛋白、血小板下降幅度比较,差异无统计学意义(P>0.05);A组白细胞下降幅度小于B组(P<0.05),输注红细胞单位数、输注血小板单位数少于B组(P<0.05)。A组出血、骨髓抑制发生率与B组比较,差异无统计学意义(P>0.05);A组骨髓恢复时间短于B组(P<0.05)。A组肾脏毒性发生率与B组比较,差异无统计学意义(P>0.05);A组非血液学不良反应胃肠道反应、肝脏毒性、心脏毒性、感染发生率低于B组(P<0.05)。结论:CAG预激方案治疗老年初治AML患者与标准剂量方案相比,有效率与完全缓解率相当,但其化疗强度温和,可缩短骨髓恢复时间,减少输血次数,不良反应少,安全性高。Objective:To explore the effects of CAG regimen and standard dose regimen on induced remission rate and adverse reactions in newly treated elderly patients with acute myelogenous leukemia(AML)(except for type AML-3).Methods:Sixty elderly patients with AML in the hospital were retrospectively enrolled between July 1,2015 and April 30,2017.According to different induced remission methods,32 cases treated with CAG pre-excitation regimen were included in group A,while another 28 cases treated with routine-dose DA regimen were included in group B.The induced remission rate and adverse reactions were compared between the two groups.Results:There was no significant difference in response rate of treatment between groups A and B(71.88%vs 78.57%)(P>0.05).Before and after treatment,there was no significant difference in decrease amplitude of hemoglobin or platelet between the two groups(P>0.05).Before and after treatment,decrease amplitude of white blood cells in group A was less than that in group B,number of red blood cells and platelets transfusion per unit was less than that in group B(P<0.05).There was no significant difference in incidence of bleeding or bone marrow suppression between groups A and B(P>0.05).The recovery time of bone marrow in group A was shorter than that in group B(P<0.05).There was no significant difference in incidence of renal toxicity between groups A and B(P>0.05).The incidence rates of non-hematological adverse reactions(gastrointestinal reactions,liver toxicity,cardiac toxicity,infection)in group A were lower than those in group B(P<0.05).Conclusion:The response rate and complete remission rate of CAG pre-excitation regimen and standard dose regimen are comparable in the treatment of newly treated elderly patients with AML.However,chemotherapy intensity of the former is mild,which can shorten recovery time of bone marrow,and reduce times of blood transfusion,with fewer adverse reactions and higher safety.

关 键 词：急性髓系白血病 老年 标准剂量方案 CAG方案 诱导缓解率 不良反应 

分 类 号：R733.7[医药卫生—肿瘤]