LD—HA诱导治疗非M3型老年急性髓系白血病疗效观察

Therapeutic outcome of LD-HA regimen in the treatment of non-M3 acute myeloid leukemia in elderly patients

目的观察小剂量高三尖杉酯碱＋阿糖胞苷（LD—HA）诱导治疗非M3型老年急性髓系白血病（AML）的疗效和不良反应。方法将35例初治老年AML患者随机分为A组（19例）及B组（16例）。A组采用LD—HA方案：高三尖杉酯碱（H）1～2mg／d，阿糖胞苷（Ara—C）25mg，q12h，第1—14天化疗。B组采用标准剂量HA或DA方案。结果1个疗程结束后，A组和B组的完全缓解（CR）率分别为68．4％和37．5％；病死率分别为10．5％和18．7％，差异有统计学意义。血液学毒性两组差异无统计学意义；非血液学毒性的发生率A组低于B组。结论LD—HA诱导治疗老年AML近期疗效好，不良反应较轻。

Objective To observe the therapeutic outcome and adverse reaction of low-dose homoharringtonine and cytarabine （ LD-HA ） in the treatment of non-M3 acute myeloid leukemia （ AML ） in elderly patients. Methods 35 elderly patients with non-M3 AML were divided into group A （n= 19） and group B （n = 16） randomly. Group A was treated with LD-HA： homoharringtonine （ H ） 1-2 mg/d and Ara-C 25 mg, per 12 h, 1-14d, and group B was treated with the recommended dose HA or DA regimen. Results After one course of induction therapy, the complete remission （CR） rates of group A and B were 68.4% and 37.5%, respectively （P〈 0.05）. The morbidity and mortality rates of group A were significantly lower than those of group B. There was no significant difference in bone marrow suppression between group A and B. Damages to the heart, liver, kidneys and digestive tract were significantly lower in group A than those in group B. Conclusion LD-HA schema offers a higher CR rate and has fewer adverse reaction in the treatment of non-M3 AML in elderly patients.