FLAG和MEA方案治疗难治复发性急性髓系白血病疗效分析

Therapeutic effect of FLAG regime and MEA regime on refractory and relapse acute myeloid leukemia

目的探讨氟达拉滨联合大剂量阿糖胞苷、重组人粒细胞集落刺激因子(FLAG)方案及米托蒽醌、足叶乙甙及阿糖胞苷(MEA)方案治疗难治复发性急性髓系白血病的临床疗效及不良反应。方法难治复发性急性髓系白血病患者63例,按不同化疗方案分为使用FLAG方案者33例(FLAG组)与使用MEA方案化疗者30例(MAE组),比较2组完全缓解率、部分缓解率,粒细胞缺乏持续时间、侵袭性真菌感染发生率及非血液学不良反应发生率。结果 FLAG组完全缓解率与侵袭性真菌感染发生率明显高于MEA组(P<0.05),部分缓解率与粒细胞缺乏持续时间均稍高于MEA组,但差异均无统计学意义(P>0.05);2组非血液学不良反应发生率均为100%,差异无统计学意义(P>0.05)。结论 FLAG方案治疗难治复发性急性髓系白血病疗效优于MEA方案,其不良反应可被患者接受。

Objective To evaluate the curative effect of FLAG regime （fludarabine, cytarabine and recombinant human granulocyte colony stimulating factor） and MEA regime （mitoxantrone, etoposide and cytarabine） on patients with refractory and relapse acute myeloid leukemia （rrAML） and their adverse reactions. Methods In 63 cases of rrAML, 33 cases received FLAG regime （FLAG group） and 30 received MEA regime （MEA group）. The complete remission rate, partial remission rate, agranulocytosis duration, the invasive fungal infection incidence and the incidence of non hematological toxicities were compared between two groups. Results The complete remission rate and the invasive fungal infection incidence were higher in FLAG group than those in MEA group （P〈0.05）. The partial remission rate and the agranulocytosis duration were higher in FLAG group, with no significant difference between two groups （P〉0.05）. The incidence of non-hematological toxieites was 100% in both two groups, showing no significant difference （P〉0.05）. Conclusion FLAG regime is much more effective than MEA regime for rrAML and its adverse reactions are acceptable.