G-HAA 方案治疗难治、复发性急性髓系白血病的疗效观察
G-HAA 방안치료난치、복발성급성수계백혈병적료효관찰
Efficacy and safety of G-HAA regimen in treatment of refractory and relapsing acute myeloid leukemia
  • 万方数据
    浙江医学 절강의학
    ZHEJIANG MEDICAL JOURNAL
    2013年 2期 105-107 ,共3页

    李双月*%裴仁治%张丕胜%刘旭辉%马俊霞%杜小红%陈冬%沙科娅%陈列光%曹俊杰%庄贤栩%吴静怡%范峥%林丽%叶佩佩%唐善浩%张碧波%史晓薇

    리쌍월*%배인치%장비성%류욱휘%마준하%두소홍%진동%사과아%진렬광%조준걸%장현허%오정이%범쟁%림려%협패패%당선호%장벽파%사효미

    G-HAA方案%难治性%复发性%急性髓系白血病 G-HAA方案%難治性%複髮性%急性髓繫白血病
    G-HAA방안%난치성%복발성%급성수계백혈병
    G-HAA regimen%Refractory%Relapse%Acute myeloid leukemia
    目的评价小剂量阿糖胞苷(Ara-C)、阿克拉霉素(ACR)、高三尖杉酯碱(HHT)和粒细胞集落刺激因子(G-CSF)组成的 G-HAA 预激方案治疗难治、复发性急性髓系白血病(AML)的有效性和安全性.方法将48例难治、复发性 AML 患者分成采用 CAG 预激方案治疗的 CAG 组(23例)和 G-HAA 预激方案治疗的 G-HAA 组(25例).两组患者根据年龄再分为3个亚组:儿童亚组(≤14岁)、中青年亚组(15~59岁)和老年亚组(≥60岁).两组患者分别采用不同预激方案治疗,观察并比较其完全缓解率(CR)、部分缓解率(PR)和未缓解率(NR);评价治疗期间的不良反应.结果 CAG 组和 G-HAA 组总 CR 率分别为69.6%、76.0%,差异无统计学意义(P >0.05),总有效率(CR+PR)也无统计学差异(P >0.05);两组间 M1、M2型 AML 和骨髓增生异常综合征(MDS)转化AML 患者 CR 率的差异均无统计学意义(均 P >0.05),但两组 M4、M5型 AML 的 CR 率分别为44.4%、90.9%,差异有统计学意义(P<0.05);CAG 方案和 G-HAA 方案儿童治疗 CR 率分别为37.5%、90.0%,差异有统计学意义(P<0.05),但中青年和老年的差异均无统计学意义(均 P >0.05);进一步分析儿童亚组显示,CAG 方案和 G-HAA 方案治疗 M4、M5型 CR 率分别为20.0%、100.0%,差异有统计学意义(P<0.05),但 M1、M2型 CR 率差异无统计学意义(P >0.05);各组不良反应发生率的差异均无统计学意义(均 P >0.05).结论 G-HAA 预激方案治疗难治、复发性 AML 安全、有效,特别是对 M4、M5型 AML 疗效较 CAG 预激方案佳.
    목적평개소제량아당포감(Ara-C)、아극랍매소(ACR)、고삼첨삼지감(HHT)화립세포집락자격인자(G-CSF)조성적 G-HAA 예격방안치료난치、복발성급성수계백혈병(AML)적유효성화안전성.방법장48례난치、복발성 AML 환자분성채용 CAG 예격방안치료적 CAG 조(23례)화 G-HAA 예격방안치료적 G-HAA 조(25례).량조환자근거년령재분위3개아조:인동아조(≤14세)、중청년아조(15~59세)화노년아조(≥60세).량조환자분별채용불동예격방안치료,관찰병비교기완전완해솔(CR)、부분완해솔(PR)화미완해솔(NR);평개치료기간적불량반응.결과 CAG 조화 G-HAA 조총 CR 솔분별위69.6%、76.0%,차이무통계학의의(P >0.05),총유효솔(CR+PR)야무통계학차이(P >0.05);량조간 M1、M2형 AML 화골수증생이상종합정(MDS)전화AML 환자 CR 솔적차이균무통계학의의(균 P >0.05),단량조 M4、M5형 AML 적 CR 솔분별위44.4%、90.9%,차이유통계학의의(P<0.05);CAG 방안화 G-HAA 방안인동치료 CR 솔분별위37.5%、90.0%,차이유통계학의의(P<0.05),단중청년화노년적차이균무통계학의의(균 P >0.05);진일보분석인동아조현시,CAG 방안화 G-HAA 방안치료 M4、M5형 CR 솔분별위20.0%、100.0%,차이유통계학의의(P<0.05),단 M1、M2형 CR 솔차이무통계학의의(P >0.05);각조불량반응발생솔적차이균무통계학의의(균 P >0.05).결론 G-HAA 예격방안치료난치、복발성 AML 안전、유효,특별시대 M4、M5형 AML 료효교 CAG 예격방안가.
    Objective To evaluate the efficacy and safety of G-HAA regimen consisting of low dose cytosine arabinoside (Ara-C), aclacinomycin (ACR), homoharringtonine (HHT) and granulocyte colony stimulating factor (G-CSF) in treatment of re-fractory and relapsing acute myeloid leukemia (AML). Methods Forty eight patients with refractory and relapsing AML, admitted from March 2008 to February 2012, were randomly assigned to CAG regimen (Ara-C, aclarubicin with G-CSF) and G-HAA regi-men. The two groups were further divided into three subgroups: children group (≤14y), young and middle-aged group (15 to 59y) and elderly group (≥60y) . The efficacy and side effects were analyzed and compared between the groups. Results The total complete remission (CR) rates in CAG group and G-HAA group were 69.6% and 76.0%, respectively (P >0.05) ; the overal effective rates (CR+PR) were 87.0% and 92.0%, respectively (P >0.05). The CR rates for M4、M5 subtype were 44.4% and 90.9%, in two groups respectively (P<0.05); but there was no difference in CR rates for M1、M2 subtype and MDS transformation. In chil-dren group, the CR rate treated with CAG regimen and G-HAA regimen were 37.5% and 90.0% respectively (P<0.05) , but there were no differences in the other two age groups. Further analysis of the children's group demonstrated that the CR rates for M4、M5 subtype of CAG regimen and G-HAA regimen were 20.0% and 100.0% respectively (P<0.05); but there were no differences in M1、M2 subtype. There were no significant differences in side effects among the groups. Conclusion The results indicate that the G-HAA regimen has the same efficacy and safety as CAG regimen in treatment of refractory and relapsing AML, however G-HAA regimen might be more effective in M4、M5 subtype, particularly in child patients.
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