改良FLAG方案治疗难治性急性髓细胞白血病的初步分析  

Modified FLAG regimen in the management of refractory acute myeloid leukemia

作　　者：杨龙江[1] 孟凡义[1] 徐兵[1] 刘晓力[1] 郑维扬[1] 张钰[1] 黄芬[1] 徐丹[1] 孙竞[1] 刘启发[1] 

机构地区：[1]第一军医大学南方医院血液科,广东广州510515

出　　处：《第一军医大学学报》2003年第10期1054-1055,共2页Journal of First Military Medical University

基　　金：广东省社会发展攻关课题(B30202)~~

摘　　要：目的研究改良FLAG方案治疗难治性急性髓细胞白血病(AML)的疗效.方法16例成人难治性AML患者分为2组.改良组10例接受氟达拉宾50 mg/d,VD×5 d和Ara-C 200mg/d,VD×5或7 d;经典组6例氟达拉宾用法同改良组,Ara-C 500或1000 mg/d,VD×5 d并在化疗前4～6 h皮下注射G-CSF 300μg/d.所有患者化疗后WBC 1.0×109/L以下时加用G-CSF 300μg/d,至WBC 3.0×109以上.结果16例难治性AML的完全缓鲜率(CR)为50%.改良组CR率高于经典组(70%vs17%,P＜0.05).改良组感染发生率低于经典组(50%vs83%).结论改良FLAG方案治疗难治性AML在CR率和降低感染并发症方面可能比经典FLAG方案优越.Objective To evaluate the therapeutic effect of modified FLAG regimen in the management of refractory acute myeloid leukemia (AML). Methods Sixteen patients with refractory AML were divided into two groups. In modified FLAG regimen group (n=10), the patients received fludarabine (Flu, 50 mg/d, VD×5 d) and Ara-c (200 mg/d, VD×5 or 7 d). The regimen for classic FLAG group (n=6) consisted of Flu (50 mg/d, VD×5d), Ara-C (500 or 1 000 mg/d, VD×5d) and G-CSF (300 μg/d, ×5 d, subcutaneously injected 4-6 hours before chemotherapy). Each patient received subcutaneous G-CSF (300 μg/d) when the white blood cell count was lower than 1.0×10 9 /L till the condition was corrected. Results The total complete remission(CR) rate of the 16 patients was 50% (8/16). Seven patients in modified group achieved CR (70%) and only one of the classic group did (17%, P<0.05). Episodes of infections were lower in modified group than in the classic group (50% vs83%). Conclusion Modified FLAG regimen is more likely than classic FLAG regimen to achieve CR and reduce infections in patients with refractory AML.

关 键 词：FLAG方案 治疗 难治性急性髓细胞白血病 氟达拉宾 粒细胞集落刺激因子 阿糖胞苷 

分 类 号：R733.7[医药卫生—肿瘤]