小剂量米托蒽醌+足叶乙甙+阿糖胞苷治疗老年急性髓系白血病疗效观察

Efficacy Analysis of the Low Dose of Mitoxantrone+Etoposide+Cytarabine in the Treatment of Old Acute Myelogenous Leukemia

目的探讨应用小剂量米托蒽醌+足叶乙甙+阿糖胞苷与常规剂量米托蒽醌+足叶乙甙+阿糖胞苷治疗老年急性髓系白血病的疗效。方法将32例老年AML患者分为两组,治疗组用米托蒽醌5mg/d,静脉滴注,第1-3天;足叶乙甙100mg/d,静脉滴注,第1-5天;阿糖胞苷100-150mg/d,第1-7天,静脉滴注。对照组米托蒽醌10mg/d,1-3天;足叶乙甙100mg/d,静脉滴注,第1-5天;阿糖胞苷150-200mg/d,第1-7天,静脉滴注。结果治疗组完全缓解(CR)率55.6%,总有效率83.3%,对照组CR率50%,总有效率78.6%。两组CR率无显著差异(p>0.05)。治疗组粒缺发生率、粒缺持续时间及发热持续时间均低于对照组,有显著差异(p<0.05)。结论小剂量米托蒽醌+足叶乙甙+阿糖胞苷治疗老年急性髓系白血病疗效确切,毒副作用少。

Objective To evaluate the efficacy of the low dose and conventional dose of mitoxantrone （MTZ, M） , etoposide （Vp16,E） , cytarabine （ Ara-c, A ） in the treatment of old acute myelogenous leukemia （AML）. Methods 32 cases with old AML were randomly divided into the low dose MEA group and conventional MEA group. 18 cases were treated with the low dose MEA （ M 5mg/d. iv. 1-3d, Vp16 lOOmg/d, iv. 1-Sd; Ara-c 100-150mg/d iv. q12h, 1-7d）. 14 cases were contrasted with conventional MEA （ M 5mg/d iv. 1-3d, Vp16 lOOmg/d, iv. 1-5 Ara-c 150-200mg/d. iv. q12h, 1-7d. ） Results Complete remission（ Cr ） rate is 55.6% , the total effective rate 83.3% in the treatment group; Cr rate is 50% , total effect rate is 78.6% in contrast group. Cr has no significant difference in the two groups （p〉0.05 ）. It is lower in the low dose MEA group with the agranulocytosis rate , agranuloagtosis time and fever time than those in the control group（p〈0.05 ） . Conclusion The low dose MEA is effective to old AML and the adverse effect is low.