FLAG方案治疗初次诱导失败的急性髓系白血病的疗效观察

Effects of FLAG Protocol in Treatment of the First Time Induced Non-remission Acute Myeloid Leukemia

为了探讨FLAG方案治疗初次诱导失败的急性髓系白血病的疗效,本研究采用FLAG方案(氟达拉宾50mg,静脉点滴,30分滴完,第1-5天;阿糖胞苷1000mg/m2,静脉点滴,第1-5天;G-CSF300μg皮下注射第0-5天)治疗19例初次诱导失败的急性髓系白血病。结果表明:19例患者中,13例达完全缓解(CR率68.4%),2例达部分缓解(PR率10.5%),总有效率78.9%。CR的患者中有5例已行异基因造血干细胞移植,目前3例均无病存活,其中存活最长的为26个月,仍处于CR期。该治疗方案毒副作用主要为骨髓抑制、中性粒细胞减少、消化道症状、轻度肝功能异常。结论:FLAG方案对初次诱导失败的急性髓系白血病疗效好,患者对毒副作用可以耐受。因此,对于初次诱导失败的急性髓系白血病患者应该及早应用FLAG方案,为患者行造血干细胞移植创造条件。

In order to evaluate the efficacy of FLAG protocol （ fludarabine, cytosine arabinoside and granulocyte colony-stimulating factor） in treatment of the first time induced non-remission acute myeloid leukemia （AML）, 19 patients with first time induced non-remission acute myeloid leukemia were treated with FLAG protocol. The results showed that out of the 19 patients 13 patients obtained complete remission （CR） and the CR rate was 68.4%, 2 patients obtained patial remission （PR） and the PR rate was 10.5%, the overall remission rate was 78.9%. Among the patients in CR 5 pa- tients had been received allogeneic stem cell transplantation, 3 patients from them survied without disease, including 1 patient has survived 26 monthes and still remains in CR. Main toxicities of this protocol were gastrointestinal side effectes, myelosuprtssion and neutropenia, slight abnormality of liver function and so on. It is concluded that the FLAG protocol should be employed for the the first time induced non-remission patients as early as possible, and provides conditions for the hematopoietic stem cell transplantation.