去甲氧柔红霉素与柔红霉素治疗初治AML的疗效分析

Analysis of clinical effect of idarubicin and daunorubicin in initial treatment of acute myeloid leukemia

目的对比分析去甲氧柔红霉素（IDr）联合阿糖胞苷与标准DA（柔红霉素联合阿糖胞苷）方案治疗初治AML（急性髓系白血病）第一疗程的疗效及不良反应。方法回顾性分析沈阳市第四人民医院肿瘤血液科2010年1月~2015年1月入院治疗的初治非早幼粒细胞AML患者89例,根据不同的化疗方案（IA或DA）将患者分为两组,比较并评价两组治疗的有效率及不良反应。结果 IA组第一疗程总有效率为94.44%,完全缓解率为55.56%,DA组分别为79.25%和32.08%。两组差异有统计学意义（P〈0.05）,IA组感染率高,其余不良反应两组间无明显差异。结论 IA方案比DA方案治疗初治非早幼粒细胞型AML患者第一疗程完全缓解率高,但IA对患者骨髓抑制时间长,感染率高,不良反应发生率与DA方案差别不大。

Objective To compare and analyze curative effect and adverse reactions of idarubicin（IDr）combined with cytosine arabinoside and DA（daunorubicin combined with cytosine arabinoside）in treatment of AML（acute myeloid leukemia）during the first course. Methods 89 patients with initial diagnosis of non-promyelocytic AML in department of tumor and hematology who were hospitalized in Shenyang Fourth People＇s Hospital from January 2010 to January 2015 were retrospectively analyzed.All the patients were divided into two groups according to their chemotherapy regimens（IA or DA）.Effective rate of treatment adverse reactions of two groups were analyzed and evaluated. Results The total effective rate of first course and complete relief rate of the IA group were 94.44% and 55.56% respectively.The total effective rate of first course and complete relief rate of the DA group were 79.25% and 32.08% respectively.The differences between two groups had statistical significance（P〈 0.05）.Infection rate of IA group was high.Other adverse reactions of two groups had significant difference. Conclusion Compared with DA regimen,complete relief rate in the first course of IA regimen in initial treatment of AML patients was higher. But IA has longer bone marrow suppression time and higher infection rate. Incidence of adverse reactions of IA and DA program has no great difference.