吡柔比星联合化疗缓解成人高危急性白血病的疗效观察

Therapeutic effects of chemotherapeutic regimen with pirarubicin for adult high-risk acute leukemia

目的 探讨吡柔比星(T)联合化疗缓解成人高危急性白血病的疗效。方法 采用含T药物治疗方案联合化疗治疗高危急性白血病29例,其中急性非淋巴细胞白血病(ANLL)18例、急性淋巴细胞白血病(ALL)8例、混合型白血病3例,选择治疗前条件类同、应用常规化疗方案的配对病例作为对照。实验组给予T+A、V+T+P/V+T+L+P、T+A+V+P(A:阿糖胞苷、V:长春新碱、P:强的松、L:左旋门冬酰胺酶)等联合化疗,对照组给予常规联合化疗。结果 实验组ANLL患者治疗有效率显著高于对照组(77.78％vs 44.44％,P=0.031)。实验组的骨髓抑制重于对照组,化疗后白细胞平均最低值、红细胞平均输注量和感染发生率在两组问均存在显著性差异(P分别为0.033、0.049和0.012)。结论 含吡柔比星的药物治疗联合化疗较常规药物联合化疗治疗ANLL有更好的效果,但骨髓抑制明显,感染的发生率高。

Objective To evaluate the therapeutic effects of chemotherapeutic regimen with pirarubicin in the management of adult high-risk acute leukemia. Methods Twenty-nine high-risk acute leukemia patients were selected as the treatment group and another 29 patients with similar pretreatment conditions as the control group. In the treatment group, 18 patients had acute non-lymphocytic leukemia (ANLL), and 8 had acute lymphocytic leukemia (ALL) and 3 had mixed leukemia, all received treatment regimens with pirarubicin+cytarabine, vincristine+pirarubicin+prednisone, Vincristine+pirarubicin+L-asparaginase (L)+prednisone or pirarubicin+cytarabine+vincristine+prednisone. Routine therapeutic regimens were adopted in the management of the control. Results In ANLL patients, the overall remission rate was significantly higher in the treatment group than in the control group (77.78% vs 44.44%, P=0.031). Paitents in the treatment group had greater marrow suppression and higher incidence of infections than the control group (P=0.012). Conclusion Regimens with pirarubicin is more effective than the routine regimens in the management of patients with high-risk ANLL and produce greater but tolerable marrow suppression.