中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
1期
50-53
,共4页
杨斌%王彪%顾伟英%华晓莹%凌云%钱新瑜%曹祥山
楊斌%王彪%顧偉英%華曉瑩%凌雲%錢新瑜%曹祥山
양빈%왕표%고위영%화효형%릉운%전신유%조상산
急性髓细胞白血病%去甲氧柔红霉素%柔红霉素%阿糖胞苷%司莫司汀%完全缓解
急性髓細胞白血病%去甲氧柔紅黴素%柔紅黴素%阿糖胞苷%司莫司汀%完全緩解
급성수세포백혈병%거갑양유홍매소%유홍매소%아당포감%사막사정%완전완해
Acute myeloid leukemia%ldarubicin%Daunorubicin%Cytarabine%Semustine%Complete remission
目的 探讨减低剂量去甲氧柔红霉素、阿糖胞苷联合司莫司汀(IAS)方案治疗急性髓细胞白血病(AML)的临床疗效和不良反应.方法 将58例初诊AML患者采用随机数字表法分为两组,其中IAS组30例,DA组(柔红霉素+阿糖胞苷)28例.IAS方案具体为去甲氧柔红霉素8～10mg/(m2·d),第1～3天,静脉注射；阿糖胞苷100～150 mg/(m2·d),第1～7天,静脉滴注；司莫司汀200 mg,化疗前1d口服.DA方案具体为柔红霉素40 ～60 mg/(m2·d),第1～3天,静脉注射；阿糖胞苷100～150 mg/(m2·d),第1～7天,静脉滴注.以完全缓解率和总有效率作为疗效观察指标.结果 1个疗程化疗结束后IAS组完全缓解率为80.0％ (24/30),总有效率为86.7％ (26/30)；DA组完全缓解率为57.1％ (16/28),总有效率为64.3％ (18/28),两组间完全缓解率、总有效率差异均有统计学意义(x2值分别为4.167和3.962,P均＜0.05).化疗的不良反应主要为骨髓抑制和粒细胞缺乏所致的感染,未见严重的非血液系统不良反应,两组不良反应发生率差异无统计学意义[ 96.7％( 29/30)、92.9％( 26/28),x2=0.004,P＞0.05].结论 IAS诱导方案疗效优于DA方案,不良反应可耐受,可以作为初治AML患者高效安全的化疗方案.
目的 探討減低劑量去甲氧柔紅黴素、阿糖胞苷聯閤司莫司汀(IAS)方案治療急性髓細胞白血病(AML)的臨床療效和不良反應.方法 將58例初診AML患者採用隨機數字錶法分為兩組,其中IAS組30例,DA組(柔紅黴素+阿糖胞苷)28例.IAS方案具體為去甲氧柔紅黴素8～10mg/(m2·d),第1～3天,靜脈註射；阿糖胞苷100～150 mg/(m2·d),第1～7天,靜脈滴註；司莫司汀200 mg,化療前1d口服.DA方案具體為柔紅黴素40 ～60 mg/(m2·d),第1～3天,靜脈註射；阿糖胞苷100～150 mg/(m2·d),第1～7天,靜脈滴註.以完全緩解率和總有效率作為療效觀察指標.結果 1箇療程化療結束後IAS組完全緩解率為80.0％ (24/30),總有效率為86.7％ (26/30)；DA組完全緩解率為57.1％ (16/28),總有效率為64.3％ (18/28),兩組間完全緩解率、總有效率差異均有統計學意義(x2值分彆為4.167和3.962,P均＜0.05).化療的不良反應主要為骨髓抑製和粒細胞缺乏所緻的感染,未見嚴重的非血液繫統不良反應,兩組不良反應髮生率差異無統計學意義[ 96.7％( 29/30)、92.9％( 26/28),x2=0.004,P＞0.05].結論 IAS誘導方案療效優于DA方案,不良反應可耐受,可以作為初治AML患者高效安全的化療方案.
목적 탐토감저제량거갑양유홍매소、아당포감연합사막사정(IAS)방안치료급성수세포백혈병(AML)적림상료효화불량반응.방법 장58례초진AML환자채용수궤수자표법분위량조,기중IAS조30례,DA조(유홍매소+아당포감)28례.IAS방안구체위거갑양유홍매소8～10mg/(m2·d),제1～3천,정맥주사；아당포감100～150 mg/(m2·d),제1～7천,정맥적주；사막사정200 mg,화료전1d구복.DA방안구체위유홍매소40 ～60 mg/(m2·d),제1～3천,정맥주사；아당포감100～150 mg/(m2·d),제1～7천,정맥적주.이완전완해솔화총유효솔작위료효관찰지표.결과 1개료정화료결속후IAS조완전완해솔위80.0％ (24/30),총유효솔위86.7％ (26/30)；DA조완전완해솔위57.1％ (16/28),총유효솔위64.3％ (18/28),량조간완전완해솔、총유효솔차이균유통계학의의(x2치분별위4.167화3.962,P균＜0.05).화료적불량반응주요위골수억제화립세포결핍소치적감염,미견엄중적비혈액계통불량반응,량조불량반응발생솔차이무통계학의의[ 96.7％( 29/30)、92.9％( 26/28),x2=0.004,P＞0.05].결론 IAS유도방안료효우우DA방안,불량반응가내수,가이작위초치AML환자고효안전적화료방안.
Objective To evaluate the clinical efficacy and toxicity of reduced dose idarubicin and cytarabine,semustine(IAS) regimen as induction therapy in patients with acute myeloid leukemia.Methods A total of fifty-eight newly acute myeloid leukemia(AML) patients were randomly divided into 2 groups,including 30 cases with IAS regimen,28 cases with DA regimen The IAS regimen was treated with reduced dose idarubicin (8 ～ 10 mg/m2,days 1 to 3) and cytarabine( 100 ～ 150 mg/m2,days 1 to 7),semustine(200mg,d0).The DA regimen was treated with daunorubicin(40 ～60 mg/m2,days 1 to 3) and cytarabine ( 100 ～ 150 mg/m2,days 1 to 7).The responses ( CR and overall response rate ) were compared between the 2 groups.Results Complete remission(CR) rate in IAS and DA groups were 24 of 30( 80.0％ ) and 16 of 28 (57.1％ ) respectively,while the overall response rate were 26 of 30 ( 86.7％ ) and 18 of 28 ( 64.3％ ) respectively.There was significant difference in CR rate and overall response rate between IAS group and DA group( P ＜ 0.05 ).Myelosuppression and infections due to neutropenia were the most frequent adverse effects,severe nonhematologic toxicity was not observed.The incidence rates of toxicities in the 2 groups were not significantly different ( P ＞ 0.05 ).Conclusion The effect of reduced dose idarubicin and cytarabine,semustine regimen in the treatment for acute myeloid leukemia is superior to that of DA regimen,and the toxicities are tolerable.IAS regimen can be as the optional induction therapy in newly patients with acute myeloid leukemia.
