Hyper—CVAD方案治疗成人急性淋巴细胞白血病的疗效及安全性评价

Efficacy and safety of Hyper-CVAD regimen for patients with adult acute lymphocytic leukemia

目的评价Hyper—CVAD方案治疗成人急性淋巴细胞白血病（AIJL）的临床疗效及安全性。方法将我院2006年1月至2009年6月初治的66例成人ALL患者中接受Hyper—CVAD方案的分为研究组（36例），接受常规化疗方案者为对照组（30例），通过比较2组完全缓解率和总生存率等参数，回顾性分析初发成人ALL患者接受Hyper—CVAD方案的疗效及毒副反应。结果研究组与对照组的完全缓解率分别为86．1％（31／36）和63．3％（19／30），组间差异有统计学意义（P〈0．05）；性别、年龄、有无肝脾及淋巴结肿大、白细胞数量、血红蛋白水平、血小板数量、有无中枢神经系统受累、免疫分型及染色体核型对Hyper-CVAD方案的完全缓解率无明显影响。生存评估分析发现，研究组1、2、3年总生存率分别为88．9％（32例）、80．6％（29例）和66．7％（24例），而对照组分别为73．3％（22例）、63．3％（19例）和46．7％（14例），组间差异均有统计学意义（P〈0．05）；研究组中位生存时间为30．1个月（95％CI：26．7～33．6），对照组为23．6个月（95％a：24．5～30．2），组间差异有统计学意义（P〈0．05）。2组患者诱导缓解期间的病死率及毒副反应发生率未见明显差异。结论Hyper—CVAD方案治疗成人ALL疗效满意，安全性良好，毒副反应易于控制。

Objective To evaluate the clinical efficacy and safety of Hyper-CVAD regimen for patients with adult acute lymphocytic leukemia. Methods A total of 66 cases with adult acute lymphocytic leukemia were divided into treatment group treated with Hyper-CVAD regimen（ 36 cases）and control group treated with traditional chemotherapy regimen（30 cases）. The clinical efficacy and safety of the Hyper-CVAD regimen were observed. Results Compared with traditional chemotherapy, the complete response（CR） rate was significantly higher with Hyper-CVAD （P =0. 03） ： CR was 86. 1% in treatment group and it was 63.3% in control group. There was no evidence of sig- nificant association between CR rate in treatment group and gender, age, splenomegaly, hepatomegaly, lymphadenopathy, central nervous system involvement, .leukocytosis, immunophenotype and karyotype. During follow-ups, overall 1- ,2- and 3-year survival rates were 88.9% （32 cases） , 80. 6% （29 cases）and 66.7 % （24 cases）in treatment group versus 73.3% （22 cases） , 63.3% （ 19 cases） and 46. 7% （ 14 cases） in control group. The estimated mean OS （over survival）time of patients in treatment group was 30. 1 months （95 % CI： 26. 7-33. 6）and it was 23. 6 months （95% CI： 24. 5-30. 2）in control group （P 〈 0. 05 ）. The induction mortality rate and side effects showed no differences between treatment group and control group. Conclusions Hyper-CVAD regimen can be an optimistic therapy for patients with adult acute lymphocytic leukemia. Its side effects can be easily controlled.