CAG方案治疗复发性急性髓细胞白血病疗效观察

Therapeutic effect of CAG regimen on patients with recurrent acute myelocytic leukemia

目的:探讨CAG方案对复发性急性髓细胞白血病(AML)的临床疗效和不良反应。方法:选择在我院治疗的复发AML46例,复发后20例选用CAG方案:阿克拉霉素(ACR)10～14mg·m-2.d-1(第1～4天,10～14天),静脉滴注;阿糖胞苷(Ara-C)10mg·m-2·d-1q12h(第1～14天),皮下注射;粒细胞集落刺激因子(G-CSF)200μg.m-2.d-1(第1～14天),皮下注射。26例选用对照方案:①DAH:柔红霉素40mg·m-2.d-1(第1～3天);Ara-c200mg·m-2.d-1(第1～7天),高三尖杉酯碱(HHT)3～4mg·m-2.d-1(第1～7天);②MAE:米托蒽醌(Mito)10mg·m-2·d-1(第1～3天),Ara-c200mg·m-2.d-1(第1～7天),依托泊甙(VP-16)60mg.m-2.d-1(第1～5天)。结果:强化疗组26例,经上述化疗1个疗程后6例获得完全缓解(CR),部分缓解(PR)10例,未缓解(NR)10例。PR和NR20例患者中6例一般情况差,未能继续强化疗,换用CAG方案;14例予第2个疗强化疗,CR4例,NR10例;2疗程CR共10例(38.4%)。26例CAG组第1个疗程CR12例,PR10例,NR4例。PR和NR14例予以CAG第2个疗程治疗,CR8例,PR2例,NR4例,2疗程CR共18例(69.2%)。2组CR率差异有统计学意义(P<0.05)。CAG组骨髓抑制不明显,不良反应也低。结论:复发AML治疗中,CAG方案是较对照组方案更为有效的且不良应低的治疗方法。

Objective：To study therapeutic effect and toxicity of CAG regimen on patients with recurrent acute myelocytic leukemia. Method： 46 cases with recurrent acute myelocytic leukemia were chosen from June 2003 to May 2006 in our hospital. CAG regimen was used on 20 cases and intensive chemotherapy was used on 26 cases. Result：Complete remission （CR） rate in 26 patients reveiving 2 regimens of CAG were 69.2% （18/26）, superior to 38.4% （10/26） in patients receiving intensive chemotherapy. Inhibition of bone marrow and grade of other systematic toxicities were mild in patients receiving CAG regimen than those patients receiving intensive chemotherapy. Conclusion：CAG regimen may be more efficient and safer than intensive chemotherapy in recurrent acute myelocytic leukemia.