双预激方案治疗难治复发性急性髓系白血病的疗效观察

Effect of double pre treatment on refractory and relapsed acute myeloid leukemia

目的评价双预激(CHAG)方案对难治复发性急性髓系白血病(ANLL)且不能耐受大剂量化疗患者的疗效、耐受性及不良反应。方法予粒细胞集落刺激因子[G-CSF 100~200μg/(m^2·d),第1天~第14天,皮下注射]、阿克拉霉素(Acla 8~10mg/d,第1天~第8天,静脉输注)、高三尖杉酯碱[1mg/(m^2·d),第1天~第14天,静脉输注]、小剂量阿糖胞苷[Ara-C,8~10mg/(m^2·d),第1天~第14天,每12小时皮下注射]在内的CHAG方案治疗难治、复发性ANLL 9例。结果5例(55.5%)患者取得完全缓解(CR),2例(22.2%)获部分缓解(PR),总有效率77.7%。化疗期间出现骨髓抑制、继发感染及发热等不良反应,无严重不良反应。结论双预激方案治疗难治复发性ANLL疗效较好,毒副反应轻,值得临床推广。

Objectives To evaluate the double pre-excitation syndrome（ CHAG） scheme for refractory recurrent acute myeloid leukemia（ ANLL） and cannot tolerate high doses of chemotherapy in patients with efficacy, tolerability and adverse reactions. Methods Granulocyte colony stimulating factor [g-csf 100 ~ 200μg /（ m^2·d）,day 1 ~ 14 days,subcutaneous injection],Accra toxin（ Acla 8 ~ 10 mg / d,day 1 ~ 8days,intravenous）,three pointed cedar ester alkali（ 1mg /（ m^2·d）,day 1 ~ 14 days,intravenous）,to low-dose cytarabine [Ara-C,8 ~ 10 mg /（ m^2·d）,day 1 ~ 14 days,every 12 hours subcutaneous injection],CHAG scheme in the treatment of refractory,9 cases of recurrent ANLL. Results 5 cases（ 55. 5%） patients achieved complete remission（ CR）,2 cases（ 22. 2%） received partial response（ PR）,the total effective rate was 77. 7%. Shown during chemotherapy adverse reactions such as bone marrow suppression,secondary infection and fever,no serious adverse reactions. Conclusions Double preexcitation syndrome patients with refractory recurrent ANLL curative effect is good,adverse reaction,worth clinical promotion.