中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2009年
1期
22-25
,共4页
钱思轩%李建勇%洪鸣%陆化%吴汉新%仇红霞%张苏江%陈丽娟%徐卫%盛瑞兰
錢思軒%李建勇%洪鳴%陸化%吳漢新%仇紅霞%張囌江%陳麗娟%徐衛%盛瑞蘭
전사헌%리건용%홍명%륙화%오한신%구홍하%장소강%진려연%서위%성서란
白血病%非淋巴细胞%急性%抗肿瘤联合化疗方案
白血病%非淋巴細胞%急性%抗腫瘤聯閤化療方案
백혈병%비림파세포%급성%항종류연합화료방안
Leukemia%non-lymphocytic%acute%Antineoplastic combined chemotherapy protocols
目的 探讨标准剂量的IA方案诱导治疗,继以FLAG方案巩同治疗原发急性髓系白血病(AML)的疗效、不良反应及对造血干细胞采集的影响.方法 2004年5月至2008年1月收治的23例初治AML患者,染色体核型分析采用R显带技术.诱导方案为IA:去甲氧柔红霉素(IDA)12 mg·m-2·d-1,第1～3天,阿糖胞苷(Ara-C)100 mg·m-2·d-1,持续静脉点滴,第1～7天.继以FLAG方案巩固治疗,即氟达拉滨(Flud)50 mg/d,第1～5天;Ara-C 2 g·m-2·d-1,第1～5天;G-CSF 300μg/d,皮下注射,化疗前1天至第5天.结果 1个疗程结束后完全缓解(CR)率为91.3%.良好和中等预后核型患者的CR率分别为100%和91.3%.19例CR患者继之采用FLAG方案巩固治疗,9例患者在FLAG方案1～3个疗程后进行自体干细胞采集,其中6例(66.7%)采集到足够的自体造血干细胞.4例AML患者复发,23例患者中位生存期19.5个月,中位无病生存期为14个月.IA和FLAG方案化疗的不良反应主要为骨髓抑制和粒细胞缺乏所致感染,未见严重的非造血系统不良反应.结论 标准剂量的IA方案诱导继以FLAG方案巩同治疗AML疗效肯定,尤其对于良好和中等预后的AML患者.不良反应主要是骨髓抑制,1～2个疗程FLAG方案对造血干细胞可能无明显影响.
目的 探討標準劑量的IA方案誘導治療,繼以FLAG方案鞏同治療原髮急性髓繫白血病(AML)的療效、不良反應及對造血榦細胞採集的影響.方法 2004年5月至2008年1月收治的23例初治AML患者,染色體覈型分析採用R顯帶技術.誘導方案為IA:去甲氧柔紅黴素(IDA)12 mg·m-2·d-1,第1～3天,阿糖胞苷(Ara-C)100 mg·m-2·d-1,持續靜脈點滴,第1～7天.繼以FLAG方案鞏固治療,即氟達拉濱(Flud)50 mg/d,第1～5天;Ara-C 2 g·m-2·d-1,第1～5天;G-CSF 300μg/d,皮下註射,化療前1天至第5天.結果 1箇療程結束後完全緩解(CR)率為91.3%.良好和中等預後覈型患者的CR率分彆為100%和91.3%.19例CR患者繼之採用FLAG方案鞏固治療,9例患者在FLAG方案1～3箇療程後進行自體榦細胞採集,其中6例(66.7%)採集到足夠的自體造血榦細胞.4例AML患者複髮,23例患者中位生存期19.5箇月,中位無病生存期為14箇月.IA和FLAG方案化療的不良反應主要為骨髓抑製和粒細胞缺乏所緻感染,未見嚴重的非造血繫統不良反應.結論 標準劑量的IA方案誘導繼以FLAG方案鞏同治療AML療效肯定,尤其對于良好和中等預後的AML患者.不良反應主要是骨髓抑製,1～2箇療程FLAG方案對造血榦細胞可能無明顯影響.
목적 탐토표준제량적IA방안유도치료,계이FLAG방안공동치료원발급성수계백혈병(AML)적료효、불량반응급대조혈간세포채집적영향.방법 2004년5월지2008년1월수치적23례초치AML환자,염색체핵형분석채용R현대기술.유도방안위IA:거갑양유홍매소(IDA)12 mg·m-2·d-1,제1～3천,아당포감(Ara-C)100 mg·m-2·d-1,지속정맥점적,제1～7천.계이FLAG방안공고치료,즉불체랍빈(Flud)50 mg/d,제1～5천;Ara-C 2 g·m-2·d-1,제1～5천;G-CSF 300μg/d,피하주사,화료전1천지제5천.결과 1개료정결속후완전완해(CR)솔위91.3%.량호화중등예후핵형환자적CR솔분별위100%화91.3%.19례CR환자계지채용FLAG방안공고치료,9례환자재FLAG방안1～3개료정후진행자체간세포채집,기중6례(66.7%)채집도족구적자체조혈간세포.4례AML환자복발,23례환자중위생존기19.5개월,중위무병생존기위14개월.IA화FLAG방안화료적불량반응주요위골수억제화립세포결핍소치감염,미견엄중적비조혈계통불량반응.결론 표준제량적IA방안유도계이FLAG방안공동치료AML료효긍정,우기대우량호화중등예후적AML환자.불량반응주요시골수억제,1～2개료정FLAG방안대조혈간세포가능무명현영향.
Objective To investigate the efficacy and toxicity of standard-dose IA regimen (idarubi-cin and cytarabine) as induction therapy followed by FLAG regimen in patients with acute myeioid leukemia (AML), and its influence on peripheral stem cell mobilization. Methods A total of 23 previously untreated de novo AML patients were enrolled. Thirteen patients were male, and 10 female, with ages ranging from 14 to 54 (median: 41) years. Cytogenetic analysis was performed for all patients. The IA regimen contained ida-rubicin (12 mg·m-2·d-1, days 1 to 3) and cytarabine (100 mg·m-2·d-1, days 1 to 7), and the FLAG regimen contained fludarabine (50 mg/d, days 1 to 5), cytarabine (mg·m-2·d-1, days 1 to 5) and granulocyte colony-stimulating factor (G-CSF, 300 μg/d, days 0 to 5). Results After one course of in-duction therapy, the CR rate was 91.3%. The CR rate for patients with favourable and intermediate prognos-tic karyotypes was 100% and 91.3%, respectively. Nineteen patients in CR were consolidated with FLAG regimen, of which 6/9 (66.7%) patients were able to mobilize a sufficient number of CD34+ cells and suc-cessfully performed autologous stem cell transplantation. Four patients relapsed. The median survival duration was 19.5 months and median disease-free survival was 14 months. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in all patients. Conclusion IA followed by FLAG regimen is effective and well tolerable in AML patients especially in those with favourable and intermediate prognostic karyotypes, and 1 to 2 courses of this therapy shows no influence on peripheral stem cell mobilization and subsequent autologous stem cell trans-plantation.
