VDLP方案继以CAG方案治疗7例急性双表型白血病疗效观察

Effect of VDLP with CAG on treating adult biphenotypic acute leukaemia

目的:探讨VDLP方案继以CAG方案诱导治疗急性双表型白血病(BAL)的疗效。方法:对我院2006年7月～2010年4月收住的7例BAL患者前2周采用VDLP方案:长春新碱2 mg d1、d8,柔红霉素50 mg/m2d1～3,门冬酰胺酶6 000 U//?d1、d3、d5、d7、d9、d11、d13、d15,泼尼松1 mg/kg d1～14,2周后逐渐减量停药;2周后继以CAG方案:阿克拉霉素10 mg/m2×8(7～10 d),阿糖胞苷10 mg/m2肌注或皮下注射,q12 h×14 d,G-CSF300μg,皮下注射,当白细胞>20×109/L暂时停药。结果:治疗1个疗程后6例(85.7%)缓解(CR),1例部分缓解(PR),总有效率为100.0%;7例CR后均先后予以CAG、FLAG、MOAD、HAG等方案巩固化疗,在随访结束时6例患者均为CR。结论:VDLP方案继以CAG方案能明显提高BAL的诱导缓解率,化疗耐受性好,同时骨髓抑制作用相对较轻,为此类白血病较好的治疗方案。

Objective： To explore the effect VDLP with CAG on treating adult biphenotypic acute leukaemia（BAL）.Methods： Seven BAL cases admitted from July 2006 to April 2010 were treated by VDLP： Vincristine 2 mg d1,d8,dunorubicin 50 mg/m2 d1-3,aparaginase 6 000 U/m2 d1,d3,d5,d7,d9,d11,d13,d15,pednisone 1mg/kg,d1-14,with the dosage reduction after 2 weeks.The CAG was conducted： aclacinomycin 10 mg/m2×8（7-10d）;tarabine 10 mg/m2 i.m./i.h.,q12h ×14d;G-CSF 300 μg,i.h.Drug withdrawal was performed as white cell 20×109/L.Results： After one course,6 cases had complete remission（85.7%）,1 had partial remission,with total efficiency as 100.0%.Conclusions： VDLP with CAG can significantly elevate the remission rate.With more atisfactory tolerance to chemical therapy and fewer inhibitive effect,it provides fine treatment for leukemia.