CAG方案治疗急性白血病和高危骨髓增生异常综合征临床疗效观察

The clinical curative effect observation of patients with acute leukemia and high risk MDS treated by CAG regimen

目的评价CAG方案治疗初治、复发难治、继发性急性白血病(AL)和高危骨髓增生异常综合征(MDS)患者的临床疗效和不良反应。方法对210例(185例AL和25例高危MDS)患者实施CAG方案诱导缓解治疗,中位年龄50岁(≥60岁100例)。所有病例均经过一个疗程CAG方案化疗,评估其疗效和不良反应。结果 210例患者中98例(46.7%)达到完全缓解(CR),总有效率(OR)是56.7%。其中初治急性粒细胞白血病部分分化型(M2)40例患者中24例(60.0%)达到CR,OR率是70.0%。42例预后良好核型患者中40例(95.2%)达到CR,OR率是100%;92例预后中间核型患者中73例(79.4%)达到CR,OR率是84.8%。此方案最主要的不良反应是骨髓抑制。结论采用CAG方案治疗初治、复发难治、继发性AL和高危MDS患者,临床疗效肯定,不良反应较轻,主要表现为骨髓抑制,未见严重的非造血系统毒副作用。

Objective To evaluate the clinical efficacy and toxicity of CAG regimen in treatment of primary,relapsed and refractory, secondary in acute leukemia (AL)and high-risk myelodysplastic syndrome (MDS).Methods 210 patients (185 cases of AL and 25 cases of high-risk MDS)were treated with CAG regimen,median age 50 years (≥60 years of age 100 cases ).Results 1 course of chemotherapy, the clinical efficacy and adverse events were evaluated.210 cases of patients with overall response rate (OR)and complete remission (CR) rate were 56.7% and 46.7%.The primary of acute myeloid leukemia with maturation (M2)in patients with OR rate and CR rate were 70.0% and 60.0 %.42 cases of patients with good prognosis karyotype OR rate and CR rates were 100% and 95.2%;92 cases of patients with intermediate karyotype OR rate and CR rates were 84.8 %and 79.4%.The dominant clinical adverse effects were bone marrow depres-sion.Conclusion The CAG regimen may lead to favorable therapeutic effects in treatment of primary,relapsed and refractory,secondary in AL and high-risk MDS,less adverse reactions,mainly as bone marrow suppression,and no serious side effects of non-hematopoietic system.