CAJ | 학술논문

目的：探讨环孢素A （CsA）联合CAG方案治疗骨髓增生异常综合征（MDS）转化的急性髓系白血病（AML）的疗效和不良反应。方法对16例MDS／AML患者实施CsA联合CAG方案诱导治疗，1个疗程后评估疗效，无效者退出，有效者继续接受下1个疗程治疗。随访分析患者生存期，评判CsA 联合CAG方案的长期疗效。结果16例MDS／AML患者，1疗程后4例达完全缓解（CR）（25％），6例达部分缓解（PR）（38％），4例治疗失败（NR）（25％），死亡2例；2疗程CR 44％，总有效率62％。7例≥60岁的老年患者中，2疗程1例达CR ，2例达PR ，2例NR ，2例早期死亡，有效率3／7。随访14例患者中位生存时间11个月，1年、2年的生存率分别为50％、21％。临床不良反应主要为骨髓抑制，其中中性粒细胞＜0.5×109／L发生率88％，血小板＜20×109／L发生率81％。结论 CsA联合CAG方案治疗MDS／AML安全有效，疗效较为满意。
목적：탐토배포소A （CsA）연합CAG방안치료골수증생이상종합정（MDS）전화적급성수계백혈병（AML）적료효화불량반응。방법대16례MDS／AML환자실시CsA연합CAG방안유도치료，1개료정후평고료효，무효자퇴출，유효자계속접수하1개료정치료。수방분석환자생존기，평판CsA 연합CAG방안적장기료효。결과16례MDS／AML환자，1료정후4례체완전완해（CR）（25％），6례체부분완해（PR）（38％），4례치료실패（NR）（25％），사망2례；2료정CR 44％，총유효솔62％。7례≥60세적노년환자중，2료정1례체CR ，2례체PR ，2례NR ，2례조기사망，유효솔3／7。수방14례환자중위생존시간11개월，1년、2년적생존솔분별위50％、21％。림상불량반응주요위골수억제，기중중성립세포＜0.5×109／L발생솔88％，혈소판＜20×109／L발생솔81％。결론 CsA연합CAG방안치료MDS／AML안전유효，료효교위만의。
Objective To explore the clinical efficacy and toxicity of cyclosporin A (CsA) and CAG regimen on acute myelocytic leukemia ( AML ) transformed from myelodysplastic syndrome (MDS) .Methods Sixteen pa‐tients with MDS/AML were treated with CsA and CAG regimen .The initial outcome was evaluated after the first course of treatment .The responders received the second course .Fourteen patients were followed up .Life span was analysed ,and long‐term efficacy of CsA and CAG regimen was evaluated.Results After a course of treatment by CsA and CAG regimen ,four patients (25% ) experienced complete remission ,six patients (38% ) experienced partial remission ,and four patients (25% ) cured failure .The total effective rate was 62% and complete remission percentage was 44% after the second course of treatment .One patient achieved complete remission ,two achieved partial remission ,and two had no effect among seven patients whose ages exceeded sixty .One patient died of lung infection and one died of brain hemorrhage .The median time of follow up was 11 months and the survival rates were 50% and 21% at one year and two years after chemotherapy .The dominant clinical adverse effects were bone marrow depression ,with 88% of agranulocytosis ( neutrophil<0 .5 × 109/L ) and 81% of thrombocytopenia ( platelet<0 .5 × 109/L ) .Conclusion The combined CsA and CAG regimen treatment was safe and effective.