预激方案治疗难治和继发急性髓系白血病的疗效

Efficacy of priming regimen in treatment of refractory and secondary acute myeloid leukemia

目的 评价预激方案（低剂量阿糖胞苷加阿克拉霉素或高三尖杉酯碱联合粒细胞集落刺激因子）治疗难治和继发性急性髓系白血病（AML）的疗效。方法 用低剂量阿糖胞苷（Ara—C，10mg／m^2，每12小时皮下注射，第1～14天）加阿克拉霉素（Acla，10～14mg·m^-2·d^-1，静脉滴注，第1～4天）或高三尖杉酯碱（HHT，1mg·m^-2·d^-1，静脉滴注，第1～14天）联合粒细胞集落刺激因子（G-CSF，200μg·m^-2·d^-1，皮下注射，第1～14天）治疗难治和继发性AML患者10例。结果 3例患者取得完全缓解，3例获得部分缓解，总有效率60％。骨髓抑制所致发热、继发感染、出血是该方案的主要不良反应。结论 预激方案治疗难治和继发性AML安全有效。

Objective To evaluate the efficacy of the priming regimen（low dose cytarabine and aclarubicin or homoharringtonine in combination with granulocyte colony-stimulating factor）on refractory and secondary acute myeloid leukemia （AML）. Methods Ten patients with refractory and secondary AML were treated with priming regimen consisting of low-dose cytarabine（Ara-C, 10 mg · m^-2 , q12h; day 1 - 14, subcutaneously）, aclarubicin （Acla, 10 - 14 mg·m^-2·d^-1; day 1 - 4, iv） or homoharringtonine（HHT, 1 mg · m^-2·d^-1; day 1 - 14, iv）, and concurrent use of granulocyte colonystimulating factor（C-CSF, 200μg·m^-2·d^-1 , day 1 - 14, subcutaneously）. Results Three of 10 patients achieved complete remission, and 3 partial remission with a total remission rate of 60%. Myelosuppression induced fever, infection, and hemorrhage were the side effects in this regimen. Conclusion The priming regimen is safe and effective in the treatment of refractory and secondary acute myeloid leukemia.