沙利度胺联合小剂量HA方案治疗老年急性髓系白血病23例

Thalidomide combined with small dose of HA regimen in the treatment of elderly patients with acute myeloid leukemia:a report of 23 cases

目的:观察沙利度胺联合小剂量HA方案治疗老年人急性髓细胞白血病(AML)的疗效及安全性。方法:回顾分析接受沙利度胺联合小剂量HA方案治疗的老年AML患者23例的临床资料。沙利度胺100mg/d连续口服,小剂量HA方案为高三尖杉酯碱(har)1～2mg/d,静脉滴注,d1～14。阿糖胞苷(Ara-c)25～50mg/d静脉滴注,d1～14。14d为1疗程。1～2疗程结束后评价疗效。治疗1疗程达完全缓解者用常规DA、MA、EA等方案进行巩固治疗,连用2疗程不缓解者则更换方案。观察治疗效果及不良反应。结果:23例患者中,完全缓解7例,部分缓解9例,CR率30.4%,总有效率69.2%。所有患者均顺利完成化疗,不良反应除骨髓抑制外,无严重感染、出血及重要脏器损伤,无早期死亡病例。结论:沙利度胺联合小剂量HA方案治疗老年人AML疗效确切,相对安全,耐受性好。

Objective： Observation of thalidomide combined with smll dose of HA regimen in the treat- ment of elderly acute myeloid leukemia：efficacy and safety. Methods.. Petrospective analysis of receiving thalidomide combined with small dose of HA regimen in the treatment of elderly patients with the clinical dada of 23 caces with aml. Thalidomidel00mg/d continuous oral, small dose of HA scheme of homobarringtonine （har） 1 - 2mg/d, intrayenou infusion,d1-14, cytosine arabinoside（Ara-c） 25-50mg/d intrayenous infusion, d1-14,14 days forl cour- ses. After the 1-2 treatment course evaluation of efficacy, lcourses of treatment achieved complete remission with conventional DA, MA, EA plan of consolidation therapy, on 2 successive treatment dose not relieve the latter replacement programme,observation of treatment results and adverse reactions. Results：In 23 patients, complete remission in 7 cases,partial remission in 9 cases, CR rate 30.4%, total efficiency 69.2 %. All patients were successfully completed chemotherapy, adverse reaction in bone marrow suppression, no serious infection, bleeding and important organ injuries, no early death cases. Conclusion： Thalidomide combined with small dose of HA regimen in the treatment of treatment of elderly AML curative effect is accurate,sate,well tolerated.