地西他滨联合CAG方案治疗AML1-ETO^+ AML的临床效果

Clinical Efficacy of Decitabine Combined with Modified CAG Regimen for Relapse/Refractory Acute Myeloid Leukemia with AML1-ETO^+

目的:观察AML1-ETO^+复发/难治急性髓系白血病患者经地西他滨联合CAG方案治疗的临床治疗效果。方法:收集2015年6月至2016年1月我院收治的8例AML1-ETO+复发/难治急性髓系白血病患者临床资料,分析患者入院一般资料及初诊伴随症状、骨髓特点等,同时分析患者经地西他滨联合CAG方案治疗的临床观察指标及不良反应。结果:8例患者中复发1例,难治合并复发7例,初治时白细胞23.57(7.5-65.29)×10~9/L、血小板40(19-69)×10~9/L,血红蛋白107(79-131)g/L、乳酸脱氢酶313.5(124.1-865.9)U/L。8例患者经地西他滨联合CAG方案1个疗程治疗后7例症状完全缓解,1例症状未缓解,总缓解率为87.5%;本方案的不良反应为骨髓抑制,1例症状未缓解患者经FLAG方案治疗后突发心衰死亡。结论:AML1-ETO^+复发/难治急性髓系白血病患者经地西他滨联合CAG方案治疗后,各临床观察指标较理想,缓解率较高,并发症较少。

Objective：To investigate the clinical characteristics of patients with relapse-refractory acute myeloid leukemia（AML） with AML1-ETO＋,and therapeutic effcacy and side effects of decitabine combined with modified CAG regimen.Methods：Clinical data of 8 cases of AML with AML1-ETO＋ from June 2015 to January 2016 were analyzed retrospectively,including age,sex,initial symptoms,peripheral blood and bone marrow characteristics and so on.at the same time,the therapeutic effcacy and side effects of decitabine combined with modified CAG regimen were evaluated.The 8 patient were with median age of 44.5（16-59） years.Results：Among these 8 patients,1 patients were relapsed and other 7 patients were relapse/refractory patients,their median white blood cell count was 23.57（7.5-65.29）×109/L,median platelet count was 40（19-69）×109/L,median hemoglobin level was 107（79-131） g/L,median lactate dehydrogenase level was 313.5（124.1-865.9） U/L at the initial diagnosis.The results showed that after treatment with decitabine combined with modified CAG,7 patients achieved complete remission,1 patient did not achieve remission,the overall remission rate was 87.5%（7/8）.The main side effects of this regimen was myelosuppression,there were no new lung infection and other serious complications,1 case without complete remission was treated with FLAG,and died of heart failure.Conclusion：According to preliminary results of decitabine combined with modified CAG regimen for treatment of relapse/refractory AML patients with AML1-ETO＋ displays higer remission rate and lower side effects.