摘要
目的观察强化疗加重组集落刺激因子对急性髓细胞白血病治疗转归的影响。方法诱导化疗采用ＤＮＲ每日４５ｍｇ／ｍ２，静脉注射，第１天～第３天，Ａｒａ－Ｃ每日２００ｍｇ／ｍ２，静脉点滴，第１天～第７天。化疗后白细胞计数（ＷＢＣ）＜１．０×１０９／Ｌ时起加用Ｇ－ＣＳＦ，剂量为每日２００μｇ／ｍ２，皮下注射，直至ＷＢＣ计数＞３．０×１０９／Ｌ或中性粒细胞绝对值（ＡＮＣ）＞１．５×１０９／Ｌ后停用。初治急性髓细胞白血病（ＡＭＬ）１５例。结果完全缓解（ＣＲ）１２例，ＣＲ率８０％，ＰＲ１例，总有效率８６．６％，无治疗相关性死亡。治疗中未发现Ｇ－ＣＳＦ的明显副作用。对ＣＲ１２例进行了连续１２个月的随访，失访２例，持续ＣＲ（ＣＣＲ）７例，复发３例。复发者中２例于ＣＲ后不久中断治疗３个月和４个月后复发，另１例治疗４疗程后于治疗中复发。结论ＡＭＬ强化疗中加用Ｇ－ＣＳＦ对ＣＲ率无影响。
Objective To observe the treatment influence in combination infensive chemotherapy and G CSF for acute myeloid leukemia. Methods 15 patients with acute myeloid leukemias(AML) were treated with daunorubicin 45 mg/m 2 days 1 through 3,and cytosine arabinoside 200 mg/m 2 days 1 through 7. G CSF (200μg/m 2/d,subcutaneous injection) was started after chemotherapy induced white blood cell (WBC)<1.0×10 9/L until recovery form chemotherapy induced myelosuppression (WBC>3.0×10 9/L or absolute neutrophil counts ANC >1.5×10 9/L).Results The result showed that complete remission (CR) rate was 80%,part remission rate(PR) 6.6%,total effectiveness rate 86.6%. Clinical side effects possibly related to G CSF were not obvious. After follow up, 7 cases continous CR and 3 cases relapsed (2 cases relapsed after withdrwal of chemotherapy of 4 and 3 months,respectively). Conclusion G CSF combined with chemotherapy was feasible in this trial, and G CSF does not have effect on CR rate and short term relapse rate.
