小剂量柔红霉素对老年急性髓细胞白血病的临床疗效观察

Observation on the Clinical Efficacy of Low Dose of Daunorubicin on Acute Myeloid Leukemia in Elderly Patients

目的观察小剂量柔红霉素在老年急性髓细胞白血病（AML）中的应用效果。方法选择中山大学附属东华医院2008年10月至2012年5月老年AML患者30例,采用数字表法将其随机分为观察组和对照组。观察组给予柔红霉素＋阿糖胞苷（DA化疗）化疗方案,即小剂量柔红霉素30 mg/（m2·d）,第1-3天;同时给予阿糖胞苷100 mg/（m2·d）,第1-7天。对照组给予阿糖胞苷100 mg/（m2·d）,第1-7天,同时给予柔红霉素45 mg/（m2·d）,第1-3天。两组患者均连续治疗2个疗程,疗程间隔3-4周。两组患者均根据具体情况给予支持治疗。结果观察组与对照组有效率分别为66.7%和60.0%,比较两组的临床疗效其差异无统计学意义（Z=2.43,P〉0.05）。观察组和对照组化疗过程中不良反应的发生率分别为93.33%和80.00%,差异有统计学意义（P〈0.05）。结论小剂量柔红霉素联合阿糖胞苷对老年AML进行化疗,疗效显著,不良反应少,值得借鉴。

Objective To observe the application efficacy of low dose of dannorubicin in acute myeloid leukemia in elderly patients. Methods A total of 20 elderly patients with acute myeloid leukemia from Donghua Hospital Affiliated to Zhongshan University during Oct. 2008 to May. 2012 were selected and divided into observation group and control group. Observation group adopted DA chemotherapy regimen ： low dose of daunorubicin 30 mg/（ m2 · d） for day 1-3, and at the same time given cytarabine 100 rag/（ m2 · d） for day 1-7. Control group were given cytarabine 100 mg/（ m2 ·d） for day 1-7,and at the same time given daunorubicin 45 rag/（ m2 · d） for day 1-3. Both groups were given 2 courses of treatment and there was a break of 3-4 weeks between the two courses. Supporting therapy was given to the patients according to their specific conditions. Results The effective rate were 66.7% in observation group and 60.0% in control group, the difference had no statistical significance （P 〉 0.05 ）. The incidence of adverse reactions in observation group and control group were 99. 33% and 80.00%, the difference had statistical significance （ P 〈 0.05 ）. Conclusion The treatment of myeloid leukemia with the combination of low dose of daunorubicin and cytarabine has obvious effect with less adverse reactions, thus is worth of learning.