FLAG方案治疗难治复发性急性白血病的临床观察

Treatment outcome of FLAG regimen for the refractory and relapsed acute leukemia

目的:观察应用FLAG方案治疗难治复发性急性白血病的临床疗效及主要毒副反应。方法:应用FLAG方案治疗难治复发性急性白血病患者36例,其中,急性髓细胞白血病(AML)患者20例,急性淋巴细胞白血病(ALL)患者16例。氟达拉滨(Flu)50mg/d,静脉滴入,持续30min,d1～d5;阿糖胞苷(Ara-C)2g/d,Flu后4h,静脉滴入,d1～d5;粒细胞集落刺激因子(G-CSF)300μg/d,皮下注射,d0～d5。1个周期后评价疗效,有效者间隔3周后继续原方案治疗1个周期。结果:AML组CR6例(30.00%),PR10例(50.00%),NR4例(20.00%),OR率(CR+PR)80.00%,持续CR(CCR)中位时间为6个月(2～12个月)。ALL组CR5例(31.25%),PR7例(43.75%),NR4例(25.00%),OR率75.00%,CCR中位时间为4个月(2～10个月)。两组CR率差异无统计学意义,P>0.05。主要的毒副反应为骨髓抑制、发热和感染。结论:FLAG方案治疗难治复发性急性白血病安全有效,长期疗效仍需进一步观察。

OBJECTIVE： To observe the efficacy and unto- ward effects of FLAG regimen for the treatment of refractory/ relapsed acute leukemia patients. METHODS：Thirty-six patients were detected, including 20 AML patients and 16 ALL patients. All the patients were treated with FLAG regimen： Flu 50 mg/d, iv drip in 30 rain, d1--d5; Ara-C 2 g/d, 4 hours after Flu, iv drip, d1 --d5 ; G-CSF 300 μg/d, 1 h, iH d0 --d5. The outcome was evaluated after 1 cycle of treatment. The patients received good outcome continued the same regimen for 1 cycle 3 weeks later. RESULTS： In AML group, 6 cases（30. 00%）achieved completely remission （CR）, 10 cases （50.00%） achieved partial remission （PR）, 4 cases （20.00%） none remission （NR）, and the OR rate was 80. 00%. The median time of continued CR （CCR） was 6 months （2 12 months）. In Aid. group, 5 cases （31.25%） achieved CR, 7 cases（43. 75%） achieved PR, 4 cases （25. 00%） NR, and the OR rates was 75.00%. The median time of CCR was 4 months （2 10 months）. There was no significant difference between the two groups, P〉0. 05. The main untoward effects were bone marrow suppression, fever and infection. CONCLUSIONS： FLAG regimen for refractory and relapsed acute leukemia is effective. Long-term outcome needs to he observed further.