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IA方案和DA方案诱导缓解老年初治急性髓系白血病的临床疗效观察 被引量:16

Clinical Curative Efficacy of Inducing Remission for the Newly Diagnosed Aged AML Patients by Chemotherapy with IA and DA Regimens
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摘要 本研究旨在比较去甲氧柔红霉素联合阿糖胞苷(IA)和柔红霉素联合阿糖胞苷(DA)方案诱导缓解治疗老年初治急性髓系白血病(AML)的临床疗效及不良反应。回顾性分析了60例老年初治AML(M3除外)患者应用IA方案或DA方案诱导缓解治疗的临床资料。在IA组22例中男8例,女14例,中位年龄66岁;在DA组38例中男20例,女18例,中位年龄64岁。临床疗效观察指标为化疗1个疗程后的完全缓解率、总有效率和不良反应。结果表明:IA组14例患者达完全缓解(CR),CR率为63.63%,DA组12例达CR,CR率为31.58%,两组差异有统计学意义(P<0.05)。IA组与DA组患者的总有效率分别为63.63%和36.84%,两组差异有统计学意义(P<0.05)。两组化疗方案的不良反应主要包括血液学不良反应及非血液学不良反应,两组血液学不良反应主要为骨髓抑制,两组差别无统计学意义(P>0.05);非血液学不良反应差别也无统计学意义(P>0.05)。结论:对于初治老年AML患者,IA组的1个疗程缓解率和总有效率较DA组高(P<0.05),且IA组的不良反应发生并无明显增加。 This study was aimed to explore the clinical efficacy and toxicity of idarubicin(IA regimen) and daunorubicin combined with cytarabine (DA regimen) for treating aged patients with AML as induction chemotherapy.The clinical data of 60 newly diagnosed AML aged patients treated with IA or DA regimen were analyzed retrospectively.IA regimen group included 22 patients (8 male and 14 females with median age of 66 yrs),while the DA regimen group included 38 patients (20 males and 18 females with median age of 64 yrs).The complete remission rate,total effective rate and adverse effects after one chemotherapy course were compared.The results showed that the CR rate in IA regimen group was 63.63%,which was significantly higer than that in DA regimen group (31.58%)(P 〈 0.05).The total effective rate was 63.63% and 36.84% respectively in IA and DA regimen groups,there was significant difference between the two groups (P 〈 0.05).Both the hematological and non-hematological adverse effects were observed and no difference was found in the two regimen groups,neither in myelosupression (P 〉 0.05),the major hematological adverse effects,nor in non-hematological adverse effects (P 〉 0.05).It is concluded that for aged AML patients,IA regimen can achieve a higher CR rate and higher total effective rate than that in DA regimen without increase of adverse effects after one induction chemotherapy course.
出处 《中国实验血液学杂志》 CAS CSCD 北大核心 2014年第5期1282-1285,共4页 Journal of Experimental Hematology
关键词 急性髓系白血病 老年患者 去甲氧柔红霉素 阿糖胞苷 诱导化疗 acute myeloid leukemia aged patient idarubicin cytarabine induction chemotherapy
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参考文献12

  • 1Estey EH.General approach to,and perspectives on clinical research in,older patients with newly diagnosed acute myeloid leukemia/Seminars in hematology.WB Saunders,2006;43(2):89-95.
  • 2郑志海,胡建达,刘庭波,陈鑫基,李静,陈步远,郑晓云.老年急性髓系白血病诱导缓解化疗的疗效及预后分析[J].中华血液学杂志,2012,33(2):79-83. 被引量:34
  • 3Baz R,Rodriguez C,Fu AZ,et al.Impact of remission induction chemotherapy on survival in older adults with acute myeloid leukemia.Cancer,2007;110(8):1752-1759.
  • 4Lübbert M,Rüter BH,Claus R,et al.A multicenter phase II trial of decitabine as first-line treatment for older patients with acute myeloid leukemia judged unfit for induction chemotherapy.Haematologica,2012;97(3):393-401.
  • 5Fenaux P,Mufti GJ,Hellstrom-Lindberg E,et al.Azacitidine prolongs overall survival compared with conventional care regimens in elderly patients with low bone marrow blast count acute myeloid leukemia.J Clin Oncol,2010;28(4):562-569.
  • 6Appelbaum FR,Gundacker H,Head DR,et al.Age and acute myeloid leukemia.Blood,2006;107(9):3481-3485.
  • 7Ziogas DC,Voulgarelis M,Zintzaras E.A network meta-analysis of randomized controlled trials of induction treatments in acute myeloid leukemia in the elderly.Clinical therapeutics,2011;33(3):254-279.
  • 8李鑫雨,王欣,李颖,封丽丽,周慧,单宁宁,丁梅.去甲氧柔红霉素与柔红霉素联合阿糖胞苷方案治疗74例初治急性髓系白血病患者疗效分析[J].中华血液学杂志,2013,34(1):67-68. 被引量:17
  • 9Telek B,Rejto L,Kiss A,et al.Current treatment of acute myeloid leukaemia in adults.Orvosi hetilap,2012;153(7):243-249.
  • 10钱思轩,李建勇,吴汉新,陆化,仇红霞,陈丽娟,卢瑞南,徐卫,盛瑞兰.标准剂量去甲氧柔红霉素联合阿糖胞苷持续静脉点滴治疗急性髓系白血病[J].中国实验血液学杂志,2009,17(1):209-213. 被引量:23

二级参考文献28

  • 1王春森,张晋林,王晓冬.去甲氧柔红霉素和阿糖胞苷治疗老年急性髓细胞性白血病疗效观察[J].实用老年医学,2006,20(1):68-68. 被引量:5
  • 2Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissue:Report of the Clinical Advisory Committee Meeting Airlie House, Virginia, November, 1997. J Cliu Oncol, 1999, 17: 3835-3849.
  • 3Oberg G, Killander A, Bjoremm, M, et al. Long- term follow-up of patients ≥60 years old with acute myeloid leukemia treated with intensive chemotherapy. Enr J Hematol, 2002, 68: 376-381.
  • 4Leoni F, Ciollis S, Nozzoli C, et al. Idanlbicin in induction treatment of acute myeloid leukemia in the elderly. Heamatologica, 1997, 82: 13.
  • 5Giles FJ, Kantarjian HM, Cortes JE, et al. Adaptive randomized study of idarubicin and cytarabine versus troxacitabine and cytarabine versus troxacitabine and idaruhiein in untreated patient 50 years or older with adverse karyotype acute myeloid leukemia. J Clin Oncol, 2003, 21: 1722.
  • 6Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the International Working Group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol, 2003 ;21:4642 -4649.
  • 7Grimwade D, Walker H, Oliver F, et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 Trial. The Medical Research Council Adult and Children's Leukaemia Working Parties. Blood, 1998 ;92 : 2322 - 2333.
  • 8Berman E, Heller G, Santorsa J, et al. Results of a randomized trial comparing idarubicin and cytosine arabinoside with daunorubicin and cytosine arabinoside in adult patients with newly diagnosed acute myelogenous leukemia. Blood, 1991 ;77 : 1666 -1674.
  • 9Koistinm P, Raty R, Itala M, et al. Long-term outcome of intensive chemotherapy for adults with de nono acute myeloid leukemia (AML) : the nationwide AML-92 study by the Finnish Leukaemia Group. Eur J Haematol, 2007 ;78:477 -486.
  • 10No authors listed. A systematic collaborative overview of randomized trials comparing idarubicin with daunorubicin (or other anthracyclines) as induction therapy for acute myeloid leukaemia. AML Collaborative Group. Br J Haematol, 1998 ;103:100 - 109.

共引文献66

同被引文献109

  • 1赵桂兰.去甲氧柔红霉素治疗难治性急性髓系白血病的疗效分析[J].内蒙古医学院学报,2005,27(5):36-37. 被引量:4
  • 2许卫星.去甲氧柔红霉素与柔红霉素治疗老年急性非淋巴细胞白血病的疗效比较[J].中国老年学杂志,2014,34(10):2877-2878. 被引量:3
  • 3张立冬.4-去甲氧柔红霉素在白血病治疗中的应用[J].中华血液学杂志,1995,16(2):99-102. 被引量:13
  • 4Masaoka T,Agawa M,Yamade K,et al.A phase2comparative of idarubicin plus cytarabine versus dauno rubicin plus cy2tarabine in adult acute myeloid leukemia[J].Sem in Hematol,1996,33(Supp l3):12-17.
  • 5Berman E,Heller G,Santorsa J,et al.Results of randomized trial comparing idarubicin and cytosine arabinoside with daunorubicin and cytosine arabinoside in adult patients with newly diagnosed AML[J].Blood,2011,97:1666-1674.
  • 6Endami S,Singh AK,Scater NGP.A phaseⅡstudy of idarubicin versus daunorubicin in the treatment of acute non-lymphocytic leukemia[J].Cancer Journal,2012,2:296-299.
  • 7Mandelli F,Petti MC,Ardia A.A randomized clinical trial comparing idarubicin and cytarabine to daunorubicin and cytaraline in the treatment of ANLL:a multicentric study from the Italian cooperative group GIMEMA[J].European Journal of Cancer,2013,27:750-755.
  • 8Estey EH.Acute myeloid leukemia:2013 update on risk-stratification and management[J].Am J Hematol,2013,88(4):318-327.
  • 9Mandelli F,Vignetti M,Suciu S,et al.Daunorubicin versus mitoxantrone versus idarubicin as induction and consolidation chemotherapy for adults with acute myeloid leukemia:the EORTC and GIMEMA Groups Study AML-10[J].J Clin Oncol,2009,27(32):5397-5403.
  • 10Dohner H,Estey EH,Amadori S,et al.Diagnosis and management of acute myeloid leukemia in adults:recommendations from an international expert panel,an panel,on behalf of the European Leukemia Net[J].Blood,2010,115(3):453-474.

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