FLAG方案诱导化疗初治急性单核细胞白血病的临床观察

Clinical study of FLAG regimen as induction chemotherapy in the treatment of newly diagnosed acute monocytic leukemia patients

目的:初步探讨FLAG方案在初治急性单核细胞白血病(M5)诱导化疗中的临床疗效和不良反应。方法:10例初治M5患者,采用FLAG方案诱导化疗,具体用法为氟达拉滨(Flud)30mg.m-2.d-1,持续静脉滴注30min,第1～5天;阿糖胞苷(Ara-C)1g.m-2.d-1,Flud结束后4h开始,持续静脉滴注4h,第1～5天;粒细胞集落刺激因子(G-CSF)5μg.kg-1.d-1,皮下注射,第0～5天。以完全缓解率(CR)和有效率及不良反应作为观察指标。结果:1个疗程FLAG方案诱导化疗患者CR率为80%,有效率为90%。化疗的不良反应主要为骨髓抑制和粒细胞缺乏所致的感染,未见严重的非血液系统不良反应。结论:FLAG方案诱导化疗初治急性单核细胞白血病患者具有较高的CR率,不良反应可耐受。

Objective：To primarily evaluate the clinical efficacy and adverse reaction of FLAG regimen as in- duction chemotherapy for newly diagnosed patients with acute monocytic leukemia（Ms ）. Method： Ten cases of de novo adult AML Mi were treated with FLAG regimen as induction chemotherapy which included fludarabine 30 mg · m2 · d 1 over 30 min daily for 5 days and Ara C 1 g ~ m-2 · d ^-1 for 5 days over 4 hours starting after 4 hours after completion of daily fludarabine. G-CSF 5 μg.kg-1.d-1 subcutaneously daily on days 0 to 5. The complete remis- sion（CR）rate and the overall response rate and adverse reactions were studied. Result： After one course of FLAG regimen as induction chemotherapy,the CR rate in 10 patients was 80~ （8/10）,the overall response rate was 90 （9/10）. Myelosuppression and infections due to neutropenia were the most common adverse effects and severe non hematologic toxicity was not observed. Conclusion： FLAG regimen achieves higher CR rate for newly patients with Ms with acceptable toxicity. It is therefore worthy of popularization as induction chemotherapy for newly diagnosed patients with Ms.