中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2014年
11期
966-969
,共4页
王涛%马梁明%朱秋娟%贡蓉%高志林%田卫伟
王濤%馬樑明%硃鞦娟%貢蓉%高誌林%田衛偉
왕도%마량명%주추연%공용%고지림%전위위
氟拉达滨%阿糖胞苷%白血病,髓样,急性%难治病%治疗结果
氟拉達濱%阿糖胞苷%白血病,髓樣,急性%難治病%治療結果
불랍체빈%아당포감%백혈병,수양,급성%난치병%치료결과
Fludarabine%Cytarabine%Leukemia,myeloid,acute%Refractory disease%Outcome
目的 对比分析改良FLAG方案与CAG预激方案对复发难治性急性髓系白血病(AML)的疗效及安全性.方法 选择61例复发难治性AML患者,改良FLAG方案组28例,方案为G-CSF200 μg·m-2·d-1,第0～5天;氟达拉滨30 mg·m-2·d-1,第1～5天;阿糖胞苷(Ara-C)1 g·m-2·d-1,第1～5天.CAG方案组33例,方案为G-CSF 200 μg/d,第1～14天;阿克拉霉素20 mg/d,第1～4天;Ara-C 10mg·m-2· 12 h-1,第1～14天.结果 改良FLAG方案组12例达完全缓解(CR),5例达部分缓解(PR),有效率为61％;CAG方案组7例达CR,5例达PR,有效率为36％,组间比较差异有统计学意义(P＜0.05).主要不良反应为骨髓抑制、感染,改良FLAG方案组感染发生率为68％ (22例患者粒细胞缺乏期在无菌层流病房治疗),治疗相关死亡(TRM)率7％;CAG方案组感染发生率为55％(均未进入无菌层流病房),TRM率3％,感染率及TRM率组间比较差异无统计学意义(P＞0.05).结论 改良FLAG方案可有效治疗复发难治性AML患者,通过加强感染防控措施,缩短骨髓抑制时间,可进一步提高疗效.CAG方案不良反应小,可用于年老、脏器功能差的老年患者.
目的 對比分析改良FLAG方案與CAG預激方案對複髮難治性急性髓繫白血病(AML)的療效及安全性.方法 選擇61例複髮難治性AML患者,改良FLAG方案組28例,方案為G-CSF200 μg·m-2·d-1,第0～5天;氟達拉濱30 mg·m-2·d-1,第1～5天;阿糖胞苷(Ara-C)1 g·m-2·d-1,第1～5天.CAG方案組33例,方案為G-CSF 200 μg/d,第1～14天;阿剋拉黴素20 mg/d,第1～4天;Ara-C 10mg·m-2· 12 h-1,第1～14天.結果 改良FLAG方案組12例達完全緩解(CR),5例達部分緩解(PR),有效率為61％;CAG方案組7例達CR,5例達PR,有效率為36％,組間比較差異有統計學意義(P＜0.05).主要不良反應為骨髓抑製、感染,改良FLAG方案組感染髮生率為68％ (22例患者粒細胞缺乏期在無菌層流病房治療),治療相關死亡(TRM)率7％;CAG方案組感染髮生率為55％(均未進入無菌層流病房),TRM率3％,感染率及TRM率組間比較差異無統計學意義(P＞0.05).結論 改良FLAG方案可有效治療複髮難治性AML患者,通過加彊感染防控措施,縮短骨髓抑製時間,可進一步提高療效.CAG方案不良反應小,可用于年老、髒器功能差的老年患者.
목적 대비분석개량FLAG방안여CAG예격방안대복발난치성급성수계백혈병(AML)적료효급안전성.방법 선택61례복발난치성AML환자,개량FLAG방안조28례,방안위G-CSF200 μg·m-2·d-1,제0～5천;불체랍빈30 mg·m-2·d-1,제1～5천;아당포감(Ara-C)1 g·m-2·d-1,제1～5천.CAG방안조33례,방안위G-CSF 200 μg/d,제1～14천;아극랍매소20 mg/d,제1～4천;Ara-C 10mg·m-2· 12 h-1,제1～14천.결과 개량FLAG방안조12례체완전완해(CR),5례체부분완해(PR),유효솔위61％;CAG방안조7례체CR,5례체PR,유효솔위36％,조간비교차이유통계학의의(P＜0.05).주요불량반응위골수억제、감염,개량FLAG방안조감염발생솔위68％ (22례환자립세포결핍기재무균층류병방치료),치료상관사망(TRM)솔7％;CAG방안조감염발생솔위55％(균미진입무균층류병방),TRM솔3％,감염솔급TRM솔조간비교차이무통계학의의(P＞0.05).결론 개량FLAG방안가유효치료복발난치성AML환자,통과가강감염방공조시,축단골수억제시간,가진일보제고료효.CAG방안불량반응소,가용우년로、장기공능차적노년환자.
Objective To investigate the efficacy and toxicity of modified FLAG and CAG on relapsed or refractory acute myeloid leukemia (AML).Methods Sixty-one patients with relapsed or refractory AML were divided into modified FLAG or CAG group.In modified FLAG group:G-CSF 200 μg·m-2·d-1 on days 0-5; fludarabine 30 mg·m-2·d-1 on days 1-5; Ara-C 1.0 g·m-2·d-1 on days 1-5.In CAG group:Ara-C 10 mg·m-2· 12 h-1 on days 1-14,aclarubicin 20 mg/d on days 1-4,G-CSF 200 μg·m-2·d-1 on days 0 1-14.Results The complete response (CR) rate was 43％ (12/28) and the partial response (PR) rate 18％ (5/28) with the overall response (OR) rate of 61％ in modified FLAG group.CR rate was 21％ (7/33) and PR rate 15％ (5/33) with OR rate of 36％ in CAG group.There was significant statistical difference between two groups (P＜0.05).The main toxicities of these groups were myelosupression and infection.The infection rate was 68％ (19/28) in modified FLAG group (twenty-two patients were treated in the sterile laminar flow ward duing neutropenic peri-od),treatment related mortality (TRM) in modified FLAG group was 7％;The infection rate was 55％ (18/33) in CAG group (no patient was treated in the sterile laminar flow ward),TRM in CAG group was 3％.There was no significant statistical difference in two groups (P ＞ 0.05).Conclusion Modified FLAG was effective for relapsed or refractory AML.The supportive cares to strengthen infection-controlled measures and shorten the period of bone marrow suppression produced the additional effect.CAG regimen has low adverse reactions and could be individualized to elder or weak patients.
