CAJ | 학술논문

目的比较MT方案(米托蒽醌联合替尼泊苷)和DA方案(柔红霉素联合阿糖胞苷)治疗初治急性单核细胞性白血病的疗效及患者不良反应.方法将初治急性单核细胞性白血病患者40例随机(单纯随机抽样法)分成两组,MT组23例、DA组17例,分别采用MT、DA方案诱导缓解,比较两组的临床疗效及患者不良反应.结果 MT组、DA组第一次化疗完全缓解率分别为65%(15/23)、18%(3/17),总完全缓解率为83%(19/23)、47%(8/17),有效率分别为91%(21/23)、59%(10/17),两组差异均有统计学意义(P<0.05).两组均出现明显的造血功能抑制,两组间白细胞最低点、白细胞<1×10~9/L的持续时间差异无统计学意义(P>0.05),但MT组的白细胞最低点出现时间、白细胞<1×10~9/L的开始、结束时间均较迟,两组差异有统计学意义(P<0.01).结论 MT方案治疗初治急性单核细胞性白血病完全缓解率、有效率均明显优于DA方案,方案较简单、有效,可作为初治急性单核细胞性白血病诱导缓解的较佳方案.两组骨髓抑制程度相当,但MT组骨髓抑制发生时间较DA组迟,治疗同时须注意适时加强抗感染、支持治疗.
목적 비교MT방안(미탁은곤연합체니박감)화DA방안(유홍매소연합아당포감)치료초치급성단핵세포성백혈병적료효급환자불량반응.방법 장초치급성단핵세포성백혈병환자40례수궤(단순수궤추양법)분성량조,MT조23례、DA조17례,분별채용MT、DA방안유도완해,비교량조적림상료효급환자불량반응.결과 MT조、DA조제일차화료완전완해솔분별위65%(15/23)、18%(3/17),총완전완해솔위83%(19/23)、47%(8/17),유효솔분별위91%(21/23)、59%(10/17),량조차이균유통계학의의(P<0.05).량조균출현명현적조혈공능억제,량조간백세포최저점、백세포<1×10~9/L적지속시간차이무통계학의의(P>0.05),단MT조적백세포최저점출현시간、백세포<1×10~9/L적개시、결속시간균교지,량조차이유통계학의의(P<0.01).결론 MT방안치료초치급성단핵세포성백혈병완전완해솔、유효솔균명현우우DA방안,방안교간단、유효,가작위초치급성단핵세포성백혈병유도완해적교가방안.량조골수억제정도상당,단MT조골수억제발생시간교DA조지,치료동시수주의괄시가강항감염、지지치료.
Objective To compare the therapeutic and adverse effects of MT regimen (mitoxantrone plus teniposide) and DA regimen (daunorubicin plus cytarabine) on initial treatment to acute monocytic leukemia. Methods 40 patients with initial treatment to acute monocytic leukemia were randomly divided into MT group(n=23) and DA group(n=17). All patients were treated with MT or DA regimen. The result and adverse effects of the two regimens were compared. Results Complete remission(CR) rate in the first course chemotherapy in MT and DA regimen was 65 % and 18 %, respectively. The total CR rate in MT and DA regimen was 83 % and 47 % respectively. The total effective rate was 92 % and 59 %, respectively. Significant differences were found. Severe myelosuppression occurred in both groups. The counts of wbc nadir and the durations of wbc less than 1×10~9/L were not significantly different in two group. The time points of wbc nadir, the start and end time points of wbc less than 1×10~9/L were significantly later in MT group than in DA group. Conclusion MT regimen is significant better than DA regimen in inducing remission in initial treatment acute monocytic leukemia, and it is a good choice for inducing remission strategy. The degrees of myelosuppression in two groups are similar. But the occurrent time of myelosuppression is later in MT group than in DA group. The great attention should be paid to anti-infection and support therapy at time properly.