诱导缓解化疗方案治疗急性髓系白血病高龄患者的疗效及预后

目的探讨急性髓系白血病（AML）高龄患者采用CAGF阿糖胞苷（Ara—c）4-阿克那霉素（Acla）4-粒细胞集落刺激因子（G-CSF）]方案诱导缓解化疗的临床疗效及预后。方法选择2008年1月至2012年1月，本院收治的80例AML高龄患者作为研究对象。根据住院号将其随机分为两组：接受CAG诱导缓解化疗方案治疗者纳入CAG组（n=40），接受FA[氟达拉滨（Flud）4-Ara-C]方案治疗者纳入FA组（n=40）。两组患者在性别、年龄、法国一美国一英国协作组（FAB）分型、骨髓象特征等一般资料方面比较，差异无统计学意义（P〉0．05）（本研究遵循的程序符合湖北省天门市第一人民医院人体试验委员会所制定的伦理学标准，得到该伦理会批准，分组征得受试对象本人的知情同意，并与之签订临床研究知情同意书）。随访18个月，观察两组患者的缓解率和不良反应发生情况，分别对治疗疗效、复发及预后等情况进行分析比较。结果CAG组的总缓解率显著高于FA组，两组相比差异有统计学意义（P〈O．05）；CAG组患者感染、骨髓抑制和肝功能异常率显著低于FA组，两组相比差异有统计学意义（P〈0．05）；随访12和18个月时的复发率，CAG组显著低于FA组，两组相比差异有统计学意义（P〈0．05）。结论对AML高龄患者采用CAG诱导缓解化疗方案治疗可以有效的提高临床疗效，不良反应小并且复发率低，预后较好。

Objective To explore the efficacy and prognosis of acute myeloid leukemia (AML) patients with CAG [cytarabine (Ara-C)+ ake kanamycin (Acla)+ granulocyte colony-stimulating factor (GCSF)] for remission induction chemotherapy.Methods From January 2008 to January 2012,80 AML patients in our hospital were selected as the research objects.According to the number of hospitalized,patients were randomly divided into two groups:received CAG chemotherapy regimen as the CAG group (n=40),and FA [fludarabine (Flud) + Ara-C] treatment were included in FA group (n=40).Compared two groups in gender,age,France-America-Britain(FAB) type,and bone marrow features such as general data,were no significant difference (P＞0.05) (The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Tianmen First People's Hospital.Informed consent was obtained from all participants).After 18 months time follow-up,two groups were observed in patients with ease the occurrence rate and adverse reaction,respectively on the curative effect,recurrence and prognosis analysis.Results The total remission rate in CAG group was higher than that in FA group,the difference was statistically significant (P＜0.05); patients,infection,inhibition and liver function of bone marrow abnormality rates in group CAG were lower than those in FA group,the differences were statistically significant (P＜0.05).Follow-up of 12 and 18 months,recurrence rates in CAG group were lower than those in FA group,the differences were statistically significant (P＜0.05).Conclusions AML patients with CAG remission induction chemotherapy could effectively improve the clinical efficacy,adverse reaction,with lower recurrence rate and better prognosis.