| 罗广立.不同挽救化疗方案治疗初始诱导失败急性髓性白血病疗效及安全性比较[J].安徽医药,2020,24(11):2287-2290. |
| 不同挽救化疗方案治疗初始诱导失败急性髓性白血病疗效及安全性比较 |
| Clinical effects and safety comparison of different kinds of salvage chemotherapy in the treatment of patients with acute myeloid leukemia for initial induction failure |
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| DOI：10.3969/j.issn.1009?6469.2020.11.044 |
| 中文关键词: 白血病，髓样，急性/药物疗法 抗肿瘤联合化疗方案 氟达拉滨 阿糖胞苷 粒细胞集落刺激因子 挽救化疗 |
| 英文关键词: Leukemia,myeloid,acute/drug therapy Antineoplastic combined chemotherapy protocols FLAG CAG MAC Salvage chemotherapy |
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| 目的探讨氟达拉滨＋阿糖胞苷＋粒细胞集落刺激因子(FLAG)、阿柔比星 +阿糖胞苷 +粒细胞集落刺激因子(CAG)及米托蒽醌 +环磷酰胺 +阿糖胞苷(MAC)方案对初始诱导失败急性髓性白血病(AML)病人近期疗效、生存率及不良反应的影响。方法选取 2009年 7月至 2016年 7月漯河市中心医院收治的初始诱导失败 AML病人 180例，根据化疗方案不同分为 FLAG组、 CAG组及 MAC组，每组各 60例。比较三组完全缓解率(CR)、部分缓解率(PR)、总缓解率(OR)、中位无进展生存时间、中位总生存时间及不良反应发生率。结果 MAC组 CR率 51.67%显著高于 FLAG组 31.67%、CAG组 35.00%(P＜0.05)；三组 PR率比较，差异无统计学意义(P＞0.05)； MAC组 OR率 70.00%显著高于 FLAG组 41.67%(P＜0.05)；三组中位 DFS时间比较，差异无统计学意义(P＞0.05)； FLAG组、 CAG组及 MAC组中位 OS分别为 14.3(1.2~22.8)个月， 12.8(1.4~21.3)个月， 33.7(1.9~48.6)个月， MAC组中位 OS显著长于 FLAG组和 CAG组(P＜0.05)；三组肝损伤、肾损伤、腹泻及恶心呕吐发生率比较，差异无统计学意义(P＞0.05)； CAG组和 MAC组病人 Ⅰ~Ⅱ度感染发生率均显著高于 FLAG组(P＜0.05)；三组 Ⅲ~Ⅳ度感染发生率比较，差异无统计学意义(P＞0.05)。结论 MAC方案用于初始诱导失败 AML病人治疗可有效延缓病情进展，提高远期生存率，且未导致严重不良反应出现，价值优于 FLAG和 CAG方案。 |
| 英文摘要: |
| Objective To investigate the influence of FLAG，CAG and MAC on clinical effects for short?term，survival rate and ad? verse effects of patients with acute myeloid leukemia for initial induction failure.Methods 180 patients with acute myeloid leuke?mia for initial induction failure were chosen and divided according to chemotherapy scheme into 3 groups including FLAG group(50 patients)with FLAG scheme，CAG group(50 patients)with CAG scheme and MAC group(50 patients)with MAC scheme； and the CR rate，PR rate，overall remission rate，the median DFS time，the median OS time and the adverse effects incidence of 3 groups were compared.Results The CR rate of MAC group were significantly higher than FLAG group and CAG group(51.67% vs. 31.67%，35.00%，P＜0.05).There was no significant difference in the PR rate among 3 groups(P＞0.05).The OR rate of MAC group were significantly higher than FLAG group(70.00% vs. 41.67%，P＜0.05).There was no significantly difference in the medi? an PFS time among 3 groups(P＞0.05).The median OS time of MAC group were significantly longer than FLAG group and CAG group［33.7(1.9~48.6)vs. 14.3(1.2~22.8)，12.8(1.4~21.3)，P＜0.05］.There was no significant difference in the incidence of liver dysfunction，renal dysfunction，diarrhea and vomit among 3 groups(P＞0.05).The incidence of infection for Ⅰ?Ⅱ degree of CAG group and MAC group were significantly higher than FLAG group(P＜0.05).There was no significant difference in the incidence of infection for Ⅲ?Ⅳ degree among 3 groups(P＞0.05).Conclusion Compared with FLAG scheme and CAG scheme，MAC scheme in the treatment of patients with acute myeloid leukemia for initial induction failure can efficiently control the disease progression， higher the survival rate for long?term and not cause the serious adverse reactions. |
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