rhG-CSF联合低剂量TA/NA方案治疗急性髓系白血病疗效观察

The effect of rhG-CSF combined with low-dose TA/NA chemotherapy for acute myeloblastic leukemia

目的观察重组人粒细胞集落刺激因子(rhG-CSF)联合低剂量吡喃阿霉素+阿糖胞苷(THP+Ara-C,TA)或米托蒽醌+阿糖胞苷(NVT+Ara-C,NA)诱导缓解方案能否提高急性髓系白血病(AML)患者对化疗药物的敏感性并减低化疗药物的毒副反应。方法40例初治、复发的AML患者随机分为实验组和对照组,实验组21例采用rhG-CSF联合低剂量方案诱导化疗,对照组19例采用标准剂量的TA/NA方案诱导化疗。结果实验组与对照组完全缓解(CR)率分别为57.1%和52.6%,总有效率为80.9%和73.7%,2组间无差异(P>0.05);患者住院费用分别为(25623.10±19192.9)元和(29327±13771.2)元(P>0.05);住院时间分别为(29.43±13.67)天和(46.56±20.82)天,实验组住院时间较对照组缩短(P<0.05)。实验组较对照组化疗副反应相对较轻,中性粒细胞绝对值(ANC)>0.5×109/L的时间较对照组明显缩短,分别为(10.62±5.53)天和(18.68±11.53)天(P<0.05)。结论rhG-CSF联合低剂量TA/NA方案治疗AML的CR率和总有效率与标准剂量的化疗方案疗效相当,其毒副作用较轻,并可减少住院时间及缩短中性粒细胞的减低时间,而不增加住院费用。

Objective To observe whether the additional use of human recombinant granulecyte colony - stimulating factor （ rhG - CSF） to the low - dose TA/NA regimen could increase the therapeutic sensitivity in acute myeloblastic leukemia （AML） patients and decrease the adverse effects of drugs. Methods The 40 enrolled patients with AML were randomly divided into experimental and control groups. The experimental group （n = 21 ） was given rhG -CSF combined with low -dose TA/NA chemotherapy, the control group （n = 19） was given the standard dose of TA/NA chemotherapy. Results The CR rate and the total efficiency rate showed no significant differenctes between the 2 groups （ P 〉 0.05 ）. The experimental group had less side effects and shorter ANC （absolute neutrophil count） resume time than the control group （ P 〈 0.05 ）. The cost of hospitalization in the experiment and control groups were about equal （ P 〉 0.05 ）, but the hospitalization was reduced in the experimental group [from （46.56 ±20.82） days to （29.43 ±13.67） days, P〈0.05]. Conclusion rhG - CSF combined with low - dose TA/NA chemotherapy has comparable curative effect and less side effects as compared with standard TA/NA regimen, yet can shorten the length of hospitalization without increase of costs.