急性髓细胞白血病缓解后用中剂量阿糖胞苷治疗248个疗程的不良反应分析

An analysis of 248 cycles of moderate dose cytarabine for acute myeloid leukemia—outcome and side effects

背景与目的：近20年来，已认识到中剂量阿糖胞苷（MDAra—C）为主的联合化疗方案用于急性髓细胞白血病（AML）的诱导缓解和缓解后的巩固治疗可提高诱导缓解率和无病生存（DFS），但对化疗剂量增加所产生的不良反应则报道不多。本研究旨在探索MDAra—C对AML缓解后巩固治疗的不良反应和相应的防治措施。方法：以阿糖胞苷2g／m^2，静滴2—3h，q12h，连续应用6个剂量为1疗程。观察所出现的不良反应，以及采用相应措施的效果。结果：骨髓抑制较为明显，非造血系统副反应轻微，在采用相应的辅助措施后得到改善。结论：AML缓解后应用MDAra—C作巩固治疗安全而有效。

Background and purpose： In the past twenty years, the efficacy of combined regimen for acute myeloid leukemia （AML） consisted predominantly of moderate dose cytarabine （ MD Ara-C） that was used for the purpose of either to induce remission or for consolidating therapy. Data has shown that the regimen could increase the remission rate and disease-free survival （DFS） for the patients with AML, but there were a few reports about the adverse effects of the regimen. The present study is to investigate the adverse effects of MD Ara-C that was used as postremission consolidation therapy for AML, and how to prevent them with proper measures. Methods： Consecutive 6 dosages of Cytarabine （ 2g/m^2 iv, twice daily with 12 hours apart, ） were considered as a course. All of the side effects were documented and preventive treatments were taken for them. Results： After const）lidation therapy, the non-hematological adverse effects were mild, the most severe adverse effect was myelosuppression that could be reversible after appropriate treatment. Conclusions： MDAra-C is safe and efficacious for AML if used as postremission consolidation chemotherapy.