FTT方案在复发难治急性髓系白血病中的应用分析

Application of FTT Scheme on Relapsed or Refractory Acute Myeloid Leukemia

目的 观察FTT方案在复发难治急性髓系白血病中的应用.方法 对27例复发难治髓系白血病采用FTT方案（第1～4日氟达拉滨25 mg/m2,第1～5日托扑替康1.2 mg/m2,沙利度胺100～200mg/d）治疗.采用流式细胞术检测CD123表达.结果 27例患者中11例经1个疗程完全缓解（CR）,4例部分缓解（PR）,12例未达CR或PR.4例部分缓解者经该方案第2疗程化疗后有2例获完全缓解,2疗程总完全缓解率48.15％ （13/27）,总有效率55.56％ （15/27）.复发难治急性髓系白血病患者中CD123阳性表达者约占59.26％.化疗前CD123表达量43.8％（11％～74％）,化疗后CD123表达量9.6％（4％～17％）,二者比较有统计学意义（P＜0.05）.结论 FTT方案治疗复发难治急性髓系白血病具有较好疗效,可以明显降低CD123表达.

Objective To observe the application of FTT scheme on relapsed or refractory acute myeloid leukemia. Methods 27 patients with relapsed or refractory acute myeloid leukemia were treated with FTT scheme（fludarabine 25 mg/m2 d 1- 4, topotecan 1.2 mg/m2 d 1-5, thalidomide 100-200 mg/d）. The CD123 expression should be detected by flow cytometry. Results In 27 patients, 11 cases got complete remission（CR） after 1 course of treatment, 4 cases patial remission（PR）, 12 cases non - CR or PR. In the 4 cases of PR, 2 cases obtained CR after the second course of chemotherapy. The overall complete remission rate was 48.15 % （13/27）, total efficiency was 55. 56% （15/27）after 2 course of chemotherapy. Relapse or refractory acute myeloid leukemia patients with CD123 positive expression accounted for about 59.26 %. The CD123 expression level was 43.8 % （11% - 74 % ） before chemotherapy, and 9.6 % （4 % - 17 % ） after chemotherapy , there is statistical difference between the two（P 〈 0.05）. Conclusion FTT scheme has a better therapeutic effect in relapse or refractory acute myeloid leukemia, which could greaterly deereace the CD123 expression.