吡柔比星与米托蒽醌治疗初治急性髓性白血病疗效对比分析

Comparative Analysis on the Curative Effect Between Pirarubicin and Mitoxantrone in de novo Acute Myelogenic Leukemia

【目的】比较吡柔比星(pirarubicin,THP)联合阿糖胞苷(cytarabine,Ara-c)(TA组)和米托蒽醌(mitoxantrone,MIT)联合阿糖胞苷(MA组)治疗初治急性髓性白血病的疗效与不良反应。【方法】用随机研究的方法将初治76例急性髓性白血病患者分为TA组(40例)和MA组(36例)治疗,观察两组的疗效及不良反应。【结果】TA组与MA组的完全缓解率分别为82.5%、80.6%,1疗程完全缓解率分别为70.0%、66.7%,总有效率分别为87.5%、86.2%,差异均无统计学意义(P>0.05)。MA组患者化疗后严重骨髓抑制(Ⅳ度)的发生率为80.6%高于TA组的57.5%(P<0.05);骨髓抑制期发热及肺部感染的发生率分别为69.4%、27.7%亦高于TA组的42.5%、10%(P<0.05)。MA组心电图异常的发生率为16.6%高于TA组的2.5%(P<0.05)。TA组脱发的发生率为12.5%明显低于MA组的38.9%(P<0.01),且程度较低。【结论】对初治的急性髓性白血病,THP为主的联合化疗方案和MIT为主的联合化疗方案均可取得满意的疗效。与MA方案相比,TA方案的毒副作用较低。

[Objective]To compare the efficacy and adverse effects of pirarubicin plus cytarabine （TA） with mitoxantrone plus cytarabine （MA） in the treatment of acute myelogenic leukemia （AML）. [Methods] Seventy-six cases of de novo AML patients were randomly divided into two groups：TA and MA-treated group. The efficacy and adverse effects of both groups were compared. [Results]The complete remission （CR） rate was 82.5% and 80.6% in TA and MA-treated group. respectively. The CR rate in the first course of chemotherapy was 70.0% and 66.7%.and the total response rate was 87.5% and 86.2% in TA and MA group.respectively. There was no significant difference between the two groups（ P〉0.05 ）. The incidence of severe bone marrow depression in MA group （80.6%）was higher than that in TA group（57.5%）（P〈0.05） .the in cidence of fever and pneumonia infection in MA group （69. 4% .27. 7%）was higher than that in TA group （42.5% ,10%）. The incidence of abnormal ECG in MA group （16.6%） was higher than that in TA group （2. 5%）（P〈0.05）. The incidence of alopccia in TA group（12. 5%） was significantly lower than that in MA group （38.9%）（ P 〈20.01）and its degree in TA group was lower. [Conclusion]Satisfactory curative effect can be obtained with both TA and MA regimens in de novo acute myelogenic leukemia. The side effect of TA is lower.