CAJ | 학술논문

目的探讨小剂量长疗程高三尖杉酯碱和阿糖胞苷的HA方案治疗不典型慢性粒细胞白血病(aCML)的临床效果.方法选择我院2003年10月至2014年5月已确诊为aCML患者27例,治疗组14例给予小剂量长疗程HA方案,高三尖杉酯碱1.5 mg/(m2·d),阿糖胞苷100 mg/(m2·d)静脉滴注给药2周.对照组13例给予羟基脲1～3 g/d口服,重组人干扰素α-2b 3×106U隔日1次肌肉注射,连续4周.分析两组患者治疗前及治疗1、2、3、4周的白细胞计数(WBC)、血红蛋白(Hb)及血小板计数(PLT)的变化,治疗4周查血象和骨髓象评价两组治疗效果.结果两组患者治疗前和治疗1周的WBC、Hb、PLT及2周时Hb比较差异均无统计学意义(P均＞0.05),2周时WBC和PLT及3、4周时WBC、Hb、PLT比较差异均有统计学意义(P均＜0.05),重复测量资料的方差分析结果显示:两组WBC、Hb和PLT相比,差异均有统计学意义(F组间分别为833.16、145.59、143.11,P均＜0.05),不同时间点的差异亦有统计学意义(F组内分别为443.92、17.41、149.11,P均＜0.05),均存在交互作用(F交互分别为69.77、43.26、75.25,P均＜0.05).治疗组14例患者中,8例完全缓解,2例部分缓解,4例未缓解,总有效率为71.4％(10/14);对照组13例患者中,无一例完全缓解,2例部分缓解,11例未缓解,总有效率为15.4％(2/13),两组总有效率差异有统计学意义(x2=11.25,P＜0.01).结论小剂量长疗程HA方案治疗aCML的效果好,临床可操作性强,安全性好.
목적 탐토소제량장료정고삼첨삼지감화아당포감적HA방안치료불전형만성립세포백혈병(aCML)적림상효과.방법 선택아원2003년10월지2014년5월이학진위aCML환자27례,치료조14례급여소제량장료정HA방안,고삼첨삼지감1.5 mg/(m2·d),아당포감100 mg/(m2·d)정맥적주급약2주.대조조13례급여간기뇨1～3 g/d구복,중조인간우소α-2b 3×106U격일1차기육주사,련속4주.분석량조환자치료전급치료1、2、3、4주적백세포계수(WBC)、혈홍단백(Hb)급혈소판계수(PLT)적변화,치료4주사혈상화골수상평개량조치료효과.결과 량조환자치료전화치료1주적WBC、Hb、PLT급2주시Hb비교차이균무통계학의의(P균＞0.05),2주시WBC화PLT급3、4주시WBC、Hb、PLT비교차이균유통계학의의(P균＜0.05),중복측량자료적방차분석결과현시:량조WBC、Hb화PLT상비,차이균유통계학의의(F조간분별위833.16、145.59、143.11,P균＜0.05),불동시간점적차이역유통계학의의(F조내분별위443.92、17.41、149.11,P균＜0.05),균존재교호작용(F교호분별위69.77、43.26、75.25,P균＜0.05).치료조14례환자중,8례완전완해,2례부분완해,4례미완해,총유효솔위71.4％(10/14);대조조13례환자중,무일례완전완해,2례부분완해,11례미완해,총유효솔위15.4％(2/13),량조총유효솔차이유통계학의의(x2=11.25,P＜0.01).결론 소제량장료정HA방안치료aCML적효과호,림상가조작성강,안전성호.
Objective To investigate the therapeutic effect of low-dose and long-course homoharringtonine and cytarbine (HA) in treating atypical chronic myeloid leukaemia (aCML).Methods Twenty-seven patients diagnosed atypical chronic myeloid leukaemia(aCML) from Oct.2003 to May 2014.in the Affiliated Hospital of Logistics University of People's Armed Police Force were divided into treatment and control groups.Fourteen cases in the treatment group were given the chemotherapy of HA (H:1.5 mg/(m2 · d),A:100 mg/(m2· d) for two weeks,and 13 cases in the control group were given the combined therapy of Hydroxycarbamide(1-3 g/d) and recombined human interferon α-2b(3×106U by intramuscular injection every other day) for four weeks.The haemoglobin (Hb) level,the numbers of white blood cell count (WBC) and platelet count(PLT) were measured.Moreover,the clinical effects were evaluated through measured hemogram and myelogram at 4 weeks after treatment.Results The levels of Hb,the numbers of WBC and PLT at before and 1 and 2 weeks in treatment group were as same as those in control group(P＞0.05).While,the numbers of WBC and PLT at 2 weeks,as well as Hb and the numbers of WBC and PLT in 3 weeks,4 weeks in treatment group were significantly different from those in control group (P ＜ 0.05).Furthermore,repeated measurement ANOVA showed that the levels of WBC,Hb,PLT between two groups were significant (F between groups =833.16,145.59,143.11;P＜0.05),and there were significant differences at different time (F between groups =443.92,17.41,149.11;P ＜ 0.05),meanwhile with interaction (F across group =69.77,43.26,75.25;P ＜0.05).In treatment group,there was 8 cases were complete remission,2 cases were partial remission and 4 cases were not released,and the total effective rate 71.4％.While in control group,there were no one was complete remission,2 cases were partial remission and 4 cases were not released,and the total effective rate was 15.4％.And the different was significant (x2 =11.25,P＜ 0.05).Conclusion The therapeutic effect of lowdose and long-course HA in treating atypical chronic myeloid leukaemia is more efficient and practical than traditional treatment.And its side effects are tolerable.