去甲氧柔红霉素联合治疗老年性急性非淋巴细胞白血病初治患者的远期疗效

The long-term efficacy of idarubicin combined Ara-c in treatment of elderly patients with untreated acute non-lymphocytic leukemia

目的:评价去甲氧柔红霉素(IDA)在老年性急性非淋巴细胞白血病初治患者治疗中的远期疗效。方法:应用IDA加阿糖胞苷(Arac)治疗老年急性非淋巴细胞白血病初治患者27例(治疗组),并与柔红霉素加Arac治疗方案(对照组)对比分析。结果:治疗组与对照组完全缓解(CR)率分别为66.7%和52.1%,部分缓解(PR)率分别为14.8%和16.7%,差异无统计学意义(P>0.05);但治疗组获得CR后维持CR时间为(46.44±31.54)个月,较对照组(22.40±14.95)个月明显延长(P<0.01),所有CR患者中治疗组与对照组3年无病存活率分别为61.1%和20%,差异有统计学意义(P<0.05),5年无病存活率分别为33.3%和8%,差异无统计学意义(P>0.05)。结论:IDA加Arac作为老年性急性非淋巴细胞白血病初治患者的诱导缓解方案能明显延长患者的CR期,有较好的远期疗效。

Objective:To evaluate the long-term efficacy of idarubicin in the treatment of elderly patients with untreated acute nonlymphocytic leukemia (ANLL).Method:27 elderly patients (treatment group) with newly diagnosed ANLL were treated with idarubicin plus Ara-c, and 48 cases (control group) were treated with daunomycin plus Ara-c.Result:The complete remission (CR) rates and partial remission rates were 66.7% vs 52.1%, and 14.8% vs 16.7% respectively. The difference between the two groups was not significant (P> 0.05). But the remission durations of the treatment group was longer ( 46.44± 31.54 m) than that of the control group ( 22.4± 14.95 m)(P< 0.01). The disease free survival (DFS) after 3 years for CR patients was 61.1% in treatment group, and it was better than that in control group (20%)(P< 0.05). The DFS after 5 years for CR patients were 33.3% (treatment group) and 8% ( control group) respectively. The difference was not significant (P> 0.05).Conclusion:The regiment of idarubicin plus Ara-c in treatment of elderly patients with untreated ANLL can obtain good long-term efficacy.