CAJ | 학술논문

序贯诱导法治疗高危急性非淋巴细胞白血病
서관유도법치료고위급성비림파세포백혈병
Treatment to high-risk acute non-lymphocytic leukemia with sequential induction

万方数据

白血病·淋巴瘤白血病·淋巴瘤 백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2011年 3期 147-150 ,共4页

李国辉%刘利%郝淼旺%陈任安%黄斯勇%王锦程%肖芳%郭欢绪%王颖%亓晖%王萌%张静宜%何华%梁英民

리국휘%류리%학묘왕%진임안%황사용%왕금정%초방%곽환서%왕영%기휘%왕맹%장정의%하화%량영민

白血病,非淋巴细胞,急性%序贯诱导%抗肿瘤联合化疗方案%治疗结果白血病,非淋巴細胞,急性%序貫誘導%抗腫瘤聯閤化療方案%治療結果
백혈병,비림파세포,급성%서관유도%항종류연합화료방안%치료결과
Leukemia,non-lymphocytic,acute%Sequencial induction%Antineoplastic combined chemotherapy protocols%Treatment outcome

目的探讨小剂量HA(LD-HA)方案及标准方案序贯诱导法治疗高危急性非淋巴细胞白血病(ANLL)的疗效.方法对50例不适合常规诱导的高危ANLL患者(LD-HA组)进行了序贯诱导.第1个周期诱导方案为LD-HA,首次诱导仍未缓解者,更换为标准方案(DA或HA)诱导.选择同期以DA或HA方案诱导治疗的23例ANLL患者(DA/HA组)作为对照,最多诱导2个周期.结果 LD-HA组患者完全缓解率为80.0%(40/50),诱导过程死亡2例;中位无瘤生存时间为19.6个月,中位生存时间为12.2个月;1、3、5年生存率分别为57.0%、24.1%、18.8%.DA/HA组共17例完全缓解,缓解率为73.9%;中位无瘤生存时间为19.8个月,中位生存时间为12.1个月;1、3、5年生存率分别为56.58%、27.1%、27.1%,两组相比,1、3、5年生存率差异无统计学意义(x2值分别为0.009、0.237、1.807,P值均＞0.05).结论以LD-HA及标准方案序贯诱导高危ANLL患者,可获得较高的完全缓解率及长期生存率.
목적 탐토소제량HA(LD-HA)방안급표준방안서관유도법치료고위급성비림파세포백혈병(ANLL)적료효.방법 대50례불괄합상규유도적고위ANLL환자(LD-HA조)진행료서관유도.제1개주기유도방안위LD-HA,수차유도잉미완해자,경환위표준방안(DA혹HA)유도.선택동기이DA혹HA방안유도치료적23례ANLL환자(DA/HA조)작위대조,최다유도2개주기.결과 LD-HA조환자완전완해솔위80.0%(40/50),유도과정사망2례;중위무류생존시간위19.6개월,중위생존시간위12.2개월;1、3、5년생존솔분별위57.0%、24.1%、18.8%.DA/HA조공17례완전완해,완해솔위73.9%;중위무류생존시간위19.8개월,중위생존시간위12.1개월;1、3、5년생존솔분별위56.58%、27.1%、27.1%,량조상비,1、3、5년생존솔차이무통계학의의(x2치분별위0.009、0.237、1.807,P치균＞0.05).결론 이LD-HA급표준방안서관유도고위ANLL환자,가획득교고적완전완해솔급장기생존솔.
Objective To investigate the outcome of high-risk acute non-lymphocytic leukemia treated with sequential low-dose cytarabine and harringtonine(LD-HA) and standard induction. Methods 50 high-risk ANLL. patients (LD-HA group) who were regarded as unfit for intensive chemotherapy were chosen to receive LD-HA. Reinductive treatments with standard regimens would be given for those who did not achieve complete remission. 23 patients DA/HA group given two cycles of standard inductive regimens were taken as the control. Results In LD-HA group 80.0 %. (40/50) reached CR, 2 patients died shortly after inductive therapy. The median leukemia-free survival(LFS) was 19.6 months, and the median overall survival (OS) was 12.2 months. Overall survival was 57.0 % at 1 year, 24.1% at 3 years, and 18.8 % at 5 years. While the CR rate was 73.9 % for DA/HA group, and none died during the inductive therapy. LFS and OS was 19.8 months and 12.1 months, respectively. OS rate was 56.58 % at 1 year, 27.1% at 3 years, and 27.1% at 5 years.There were no difference on OS rates between 2 groups (x2 were 0.009, 0.237 and 1.807, respectively,P ＞0.05). Conclusion In patients who were unfit for intensive chemotherapy, sequential therapy with LD-HA and standard induction improved the rate of complete remission and the duration of survival.