以DA方案为主的联合化疗治疗急性髓系白血病的临床观察

COMBINED ALTERNATE CHEMOTHERAPY WITH DAUNOMYCINUM AND CYTARABINUM(DA) PROTOCOL IN THE TREATMENT OF ACUTE MYELOID LEUKEMIA

目的探讨急性髓系白血病的化疗疗效。方法采用以ＤＡ方案为主的化疗方案治疗２５例急性髓系白血病（ＡＭＬ）患者，获得完全缓解（ＣＲ）后即行ＤＡ、ＨＡ、ＥＡ或大剂量甲氨蝶呤（ＨＤ－ＭＴＸ）交替强化两次共六个疗程，与单一ＤＡ，ＨＡ或ＨＯＡＰ方案治疗１９例ＡＭＬ患者，在诱导化疗获ＣＲ后常规单一方案强化疗效比较。结果二者ＣＲ率无明显差异（Ｐ＞０．０５）（前者ＣＲ率５６％，后者ＣＲ率４７４％），二者治疗有效率亦无显著差别（Ｐ＞０．０５）（前者８００％，后者７３７％）。而二者无病生存期比较存在差异性（Ｐ＜０．０５），前者中位生存期１３５个月。后者中位生存期５个月，结论提示急性髓系白血病在诱导缓解取得ＣＲ后，即行不同的ＡＭＬ强化治疗方案交替治疗。

Objective:To explore the effect of chemotherapy on acute myeloid leukemia.Method:25 patients withe acute myeloid leukemia(AML)treated mainly according to DA therapeutic program were retreated twice after complete remission with DAHAEA or HD-MTX alternatively for six courses,the results of which were compared with those of 19 patients with AML retreated solely with DAHA or HOAP therapeutic program after complete remission.Results:There were no significant difference between the two complete remissions(P>0.05) and also between the two curative effects(P>0.05),but the disease-free survival period was longer than that in the second group(P<0.05).Conclusion:It is suggested that sequential alternate combined chemotherapy should be applied to patients with AML after the achievement of CR.