CAG与FLAG方案治疗难治或复发急性髓系白血病的疗效初步研究

The therapeutic effect of CAG regimen and FLAG regimen on patients with refractory or relapsed acute myeloid leukemia

目的比较分析CAG方案与FLAG方案治疗难治AML的疗效和不良反应。方法 28例患者应用CAG方案,另15例患者采用FLAG方案治疗。所有病例经过1个疗程化疗后评估疗效和不良反应,获得完全缓解(CR)或部分缓解(PR)的有效者均重复原方案化疗;无效者改用其他方案。结果 CAG组28例中13例获得CR,5例获得PR,总有效率64.29%,早期病死率10.71%;FLAG组15例中4例获得CR,5例获得PR,总有效率60%,早期病死率13.33%。2组方案主要不良反应为骨髓抑制。FLAG组在感染、胃肠道反应及肝损等不良反应发生率显著高于CAG组。结论 CAG方案和FLAG方案均为复发难治AML治疗的有效方案,其中CAG方案非血液学不良反应低。

Objective To study the therapeutic effect and toxicity of CAG regimen and FLAG regimen on patients with refractory or relapsed acute myeloid leukemia. Methods CAG regimen was used on 28 cases and FLAG regimen was used on 15 cases. After 1 course of chemotherapy, the efficacy and adverse events were evaluated. Patients who achieved complete remission （CR） or partial remission （PR） would receive one more cycle of chemotherapy. Patients who did not achieve remission were excluded from this regimen. Results 13 of the 28 patients that received the CAG regimen achieved CR, and 5 patients achieved PR; overall response rate was 64.29%, and the early death rate was 10.71%. 4 of the 15 patients that received the FLAG regimen achieved CR, and 5 patients achieved PR; overall response rate was 60% , and the early death rate was 13.33%. Myelosuppression was the main toxicity. The incidence of adverse events including infection, gastrointestinal toxicity, and liver abnormalities in CAG group was lower than that in FLAG group. Conclusion CAG regimen and FLAG regimen are both effective treatments for refractory or relapsed acute myeloid leukemia. A lower level of nonhematologic toxicity is observed in CAG group.