急性髓细胞白血病临床治疗研究

Clinical Research of Acute Myeloid Leukemia

目的 观察氟迭拉滨（Fludarabine，F—ara—A）、阿糖胞苷（Ara—C）及粒细胞集落刺激因子（G—CSF）（FLAG方案）治疗难治、复发性急性髓细胞白血病（AML）的疗效及不良反应。方法采用FLAG方案（F—ara—A50mg／d，第1～5d，30min内静脉滴注完毕；Ara—C2g／d，第1～5d，G—CSF300μg／d，皮下注射，第1天开始直至白细胞数〉1×10^9／L）治疗20例难治、复发性AL。结果两个疗程治疗后20例难治性及复发性白血病患者完全缓解率65％，部分缓解率10％，总有效率75％，主要不良反应为骨髓抑制，化疗期间无1例患者死亡。结论FLAG方案治疗难治或复发AML病死率低，为常规化疗无效和移植后复发的患者提供了治疗选择和接受造血干细胞移植的时机。

Objective To investigate the efficacy of FLAG regimen in refractory and relapse acute myeloid leukemia. Methods Fludarabine 50mg/d, 1 - 5days, Ara - c 2g/d, 1- 5days and G -CSF 300μg/d were used to treat 20 cases of refractory and relapsed leukemia. Results Two treatment courses later,The rate of complete remission was 65% （13/20） ,the rate of partial remission 10% （2/ 20） ,and the overall response rate 75.0%. Main toxicities were myelosupression and neutropenia, gastrointestinal side effects. No treatment - related death was observed. Conclusion FLAG regimen consisting of Fludarabine, Intermediate - dose Ara - C, G - CSF is very effective for refractory or relapsed acute leukemia and is well tolerated. The treatment - related mortality rate is low. So it provides a treat-ment choice and a chance of allo - SCT for these patients.