老年急性白血病化疗效果观察

THE TREATMENT EFFECT OF ACUTE LEUKEMIA IN THE ELDERLY.

目的 :分析老年急性白血病临床特点 ,评价疗效。方法 :对初治的老年急性白血病 2 1例进行临床分析 ,其中 60岁～ 69岁 15例 ,70岁以上 6例 ,男性 14例 ,女性 7例 ,急性髓细胞白血病(AML) 16例 ,急性淋巴细胞白血病 (AL L) 5例。治疗以小到中剂量 HA、DA、EA、COMP及 HOAP等联合化疗或小剂量三尖杉酯碱、小剂量阿糖胞苷单药化疗。结果 :总 CR率 47.6% ,AML 组 CR率5 0 .0 % ,ALL组 CR率 40 .0 % ,60岁～ 69岁 CR率 5 3 .3 % ,70岁以上 3 3 .3 %。结论 :老年急性白血病临床上有其特殊性 ,治疗上更强调个体化。总的对化疗反应差 ,缓解率低 ,生存期短 。

Objective:To analyse the clinical characteristics of acute leukemia in elderly patients and to observe their treatment effect.Methods:21 cases of newly diagnosed acute leukemia of patients ages between 60 to 78 were observed in the study, including 15 between 60～69 years old and 6 over 70,male 14,female 7,16 patients were diagnosed acute myelocytic leukemia (AML) and the other 5 were acute lymphocytic leukemia (ALL).Dizziness and easy fatigue were the most common clinical manifestation found.Chemotherapy of HA?DA?EA?COMP and HOAP regimens and small dose harringtonine or small dose Ara C were given to the patients according to their disease type and their relevant physical condition. Results:Ten patients achieved CR (CR rate 47.6 %),8 were in AML group,2 in ALL group,with CR rate of 50.0 % and 40.0 %,respectively.The CR rate of patients between 60～69 years old was 53.3 %,and that of patients over 70 was 33.3 %.Conclusion:Acute leukemia of the elderly people has its specificity in clinical appearances,and the treatment strategy should be made more individually.However, their response to chemotherapy is relatively poor,and they have a lower remission rate,shorter overall survival phase and higher mortality in comparison with patients below 60.