HA联合α-2b干扰素治疗慢性粒细胞白血病临床研究

Clincal research of HA program combimed co-α-2b interferon on treatment of chronic myeloid leukemia

目的观察HA方案（三尖杉酯碱和阿糖胞苷）联合α-2b干扰素治疗慢性粒细胞白血病的可行性及安全性。方法将本院自2005年12月至2009年1月门诊及住院CML患者51例按随机分配原则分为观察组26例和对照组25例。对照组采用α-2b干扰素3×10^6U皮下注射或肌肉注射，每周3次，肌肉注射1～12个月，缓解后改为每周2次维持；治疗组在对照组治疗基础上联用小剂量HA方案：皮下注射阿糖胞苷20mg，每12h一次；高三尖杉酯碱2mg／d加于5％葡萄糖注射射500ml中，静脉滴注4h以上，联用7～14d为1个疗程，每月重复1次，12个月后根据情况每2—3个月1次。结果观察组和对照组血液学缓解总有效率分别为96．15％（25／26）和72．0％（18／25），观察组优于对照组，2组比较，差异有显著性（P〈0．05）；观察组细胞遗传学缓解总反应率分别为76．92％（20／26）和20．0％（5／25），观察组细胞遗传学缓解总反应率优于对照组，2组比较，差异有显著性（P〈0．05）；两组患者不良反应均可耐受，不影响治疗。结论小剂量HA方案联合重组α-2b干扰素治疗CML较单用重组α-2b干扰素疗效高，具有降低白细胞效果明显，血液学缓解率高，不良反应无增加及生存期延长等优点。

Objective To observe the HA program （3 harringtonine and Ara-C） co-α-2b interferon treatment of chronic myeloid leukemia in the feasibility and safety. Methods In our hospital from December 2005 to January 2009 out-patient and hospitalization in patients with CML were randomly assigned according to the principle of 51 cases were divided into 26 cases of the observation group and control group 25 cases. The control group were treated with α-2b interferon 3×10^6U subcutaneously or intramuscularly 3 times per week, intramuscularly 1 to 12 months to ease later changed to 2 times per week to maintain; treatment group therapy in the control group based on the GC small dose of HA programs： subcutaneous injection of Ara-C 20 mg, every 12 h one time; homoharringtonine alkaline 2 mg / d plus 5% glucose solution 500 mL, by intravenous infusion over 4 h, in conjunction with the 7 - 14 d for a course of treatment monthly repeated a times, after 12 months depen- ding on the circumstances every 2 to 3 months a time. Results The observation group and the control group, hematological remission total effective rates were 96. 15 % （25/26） and 72.0% （ 18/25 ）, the observation group than the control group,2 group, the difference was significant （P 〈 0.05 ） ; the observation group cytogenetic response overall response rates were 76. 92% （20/26） and 20.0% （5 / 25）, the observation group cytogenetic response overall response rate than the control group, 2 group, the difference was significant sex （ P 〈 0.05 ） ; two groups of patients with adverse reactions can be tolerated, does not affect the treatment. Conclusion Small dose of HA regimen combined with recombinant interferon α-2b treatment of CML than single recombinant interferon α-2b high efficacy, with lower white blood cell effects of apparent high rate of hematologic response, no increase in adverse reactions and survival prolonged and so on.