小剂量MAE方案治疗难治与复发急性白血病

Chemotherapy combined with small dose MAE regimen for patients with relapsed or refractory acute myeloid leukemia

目的:探讨小剂量米托蒽醌(MTZ)、阿糖胞苷(Arc)联合依托泊甙(VP-16)治疗难治与复发急性白血病的疗效及毒副作用。方法:难治与复发急性白血病52例,应用小剂量MAE方案化疗,完全缓解后应用中剂量阿糖胞苷或预激方案巩固。结果:22例急性非淋巴细胞白血病中,10例(45.5%)达完全缓解(CR),2例(9.1%)部分缓解(PR),总有效率为54.5%;30例急性淋巴细胞白血病中,9例(30.0%)CR,2例(6.6%)PR,总有效率为36.6%。毒副作用主要是骨髓抑制、恶心、呕吐。结论:小剂量MAE方案治疗难治与复发急性白血病的疗效较好,毒副作用较轻。

Objective：To study the effect and safety of small dose mitoxantron, cytarabine combined with etoposide （MAE） for recurrent or refractory acute leukemia. Methods： All the 52 patients were reliably diagnosed recurrent or refractory acute leukemia hospitalized in our department from 2004 to 2006 . The regimen, small dose MAE, consisted of mitoxantron 3 - 4mg/m2/day, on days 1 - 3, cytarabine 80 mg/m2/day, on days 1- 5, and etoposide 100 mg/days,on days 1 -3 ,all by intravenous continuous infusion. After achievement of CR, the patients received small dose MAE, middle dose Ara - C, and the granulocyte colony - stimulating factor priming regimen simultaneously for consolidation. Results： Ten of the 22 （45.5 % ） acute myeloid leukemia （AML） patients achieved complete remission （CR） and 2 of them （9.1%） achieved part remission （PR）, 9 of the 30 （30.0%） lymphocytic leukemia （ALL） achieved CR and 2 of them （6.6%） achieved PR, the effective rate of the small dose MAE regimen for AML was 54.5% and for ALL was 36.6% , respectively. The main toxicities were myelosuppression, nausea and vomiting. Conclusion： The small dose MAE regimen is effective and well tolerated in remission induction and consolidation therapy for refractory and relapsed acute leukemia patients.