标准剂量IA方案诱导治疗年轻非M3型初治AML患者65例  

Induction therapy of standard-dose IA regimen in 65 young non-M3 primary AML patients

作　　者：郭军 童雅君 蔡绍朋 徐执政 GUO Jun;TONG Ya-jun;CAI Shao-peng(Changxing County People’s Hospital(Second Affiliated Hospital of Zhejiang University School of Medical Changxing Branch),Huzhou 313100,China)

机构地区：[1]长兴县人民医院(浙医二院长兴院区),313100

出　　处：《中国实用医药》2022年第7期1-6,共6页China Practical Medicine

摘　　要：目的观察标准剂量IA[去甲氧柔红霉素(IDA)与阿糖胞苷(Ara-C)]方案诱导治疗年轻非M3型初治急性髓细胞白血病(AML)的疗效、毒副反应。方法回顾性分析65例年轻非M3型初治AML患者,均接受标准剂量IA方案诱导治疗,统计患者临床特征、疗效、副反应发生情况、中位随访时间、总生存期(OS)、无事件生存率(EFS)。结果65例患者经1个疗程标准剂量IA方案诱导化疗后,48例完全缓解(CR)、占73.8%,12例部分缓解(PR)、占18.5%,4例未缓解(NR)、占6.2%,1例早期死亡(ED)(脑出血)、占1.5%。染色体核型预后:预后良好组的5例患者均为CR,预后中等组的52例患者中CR 37例,预后不良组的8例患者中CR 6例,预后良好组、预后中等组与预后不良组的CR率比较差异无统计学意义(P>0.05)。白细胞:5例高白细胞性白血病患者中CR 4例,占80.0%;60例非高白细胞性白血病患者中CR 44例,占73.3%;高白细胞性白血病与非高白细胞性白血病患者的CR率比较差异无统计学意义(P>0.05)。血红蛋白:23例≥100 g/L的患者中CR 20例,42例<100 g/L的患者中CR 28例;≥100 g/L与<100 g/L患者的CR率比较差异无统计学意义(P>0.05)。乳酸脱氢酶(LDH):高LDH组9例患者中CR 7例,低LDH组51例患者中CR 41例;高LDH组与低LDH组的CR率比较差异无统计学意义(P>0.05)。化疗副反应方面,65例患者均达到Ⅲ~Ⅳ度血液学反应;心脏副反应轻微,仅发现1例阵发性室上性心动过速(2度);13例患者出现Ⅰ~Ⅱ度肝功能异常;37例患者出现Ⅰ~Ⅱ度胃肠道反应(Ⅰ度14例,Ⅱ度23例)。中位随访时间12.0[0.7,50.5]个月,2年OS为65%,2年EFS为47%。65例患者中14例接受了骨髓移植。发病时骨髓原始细胞比例为OS的影响因素(P<0.05),LDH≥1000 U/L为EFS的影响因素(P<0.05)。结论标准剂量IA方案诱导治疗年轻非M3型初治AML患者1个疗程CR率较高,患者均出现Ⅲ~Ⅳ度血液学副反应,未出现Ⅲ~Ⅳ度非血液学毒性反应。FLT3-ITD突变�Objective To observe the efficacy and side effects of standard-dose IA[idamycin(IDA)and cytarabine arabinoside(Ara-C)]regimen in the induction treatment of young non-M3 primary acute myeloid leukemia(AML).Methods 65 young non-M3 primary AML patients were treated with standard-dose IA regimen induction therapy,and patients'clinical characteristics,efficacy,occurrence of side effects,median follow-up time,overall survival(OS),and event-free survival(EFS)were counted.Results After 1 course of standarddose IA regimen induction chemotherapy in 65 patients,48 cases were in complete remission(CR),accounting for 73.8%,12 cases were in partial remission(PR),accounting for 18.5%,4 cases were not in remission(NR),accounting for 6.2%,and 1 case was an early death(ED)(cerebral hemorrhage),accounting for 1.5%.Prognosis by karyotype:5 patients in the good prognosis group were all CR;37 out of 52 patients in the moderate prognosis group were in CR;6 out of 8 patients in the poor prognosis group were in CR;there was no statistically significant difference in the CR rate among the good prognosis group,the moderate prognosis group and the poor prognosis group(P>0.05).By leukocytes:4 of 5 patients with hyperleukocytic leukemia were CR,accounting for 80.0%;44 of 60 patients with non-hyperleukocytic leukemia were CR,accounting for 73.3%.There was no statistically significant difference in the CR rate between patients with hyperleukocytic leukemia and non-hyperleukocytic leukemia(P>0.05).According to hemoglobin:among 23 patients with hemoglobin≥100 g/L,20 cases were CR;among 42 patients with hemoglobin<100 g/L,28 caces were CR.There was no statistically significant difference in the CR rate between patients with hemoglobin≥100 g/L and<100 g/L(P>0.05).Lactate dehydrogenase(LDH):7 of 9 patients in the high LDH group were CR,and 41 of the 51 patients in the low LDH group were CR.There was no statistically significant difference in the CR rate between the high LDH group and the low LDH group(P>0.05).In terms of side effects of chemothe

关 键 词：急性髓细胞白血病 非M3型 标准剂量 去甲氧柔红霉素 阿糖胞苷 初治 

分 类 号：R733.71[医药卫生—肿瘤]