含G-CSF预激小剂量方案早期再诱导治疗急性髓系白血病的临床观察

Clinical observation of early re-induction with priming low dose regimen containing G-CSF in treating acute myeloid leukemia

目的评估含粒细胞集落刺激因子(G-CSF)预激小剂量方案早期再诱导治疗急性髓系白血病的缓解情况。方法回顾分析2015年3月至2017年1月该院收治的97例急性髓系白血病患者的资料,均采用标准DA方案诱导化疗,其中38例患者诱导化疗第14天存在明显残留病,21例患者采用小剂量预激方案早期再诱导化疗,17例患者采用标准DA方案再诱导化疗,比较两组患者再诱导化疗完全缓解(CR)率及不良反应。结果 97例患者总CR率为60.8%;38例需要再诱导化疗的患者中,预激方案再诱导组CR率为76.2%,明显高于DA方案再诱导组的41.2%,差异有统计学意义(P=0.028),两组患者再诱导化疗过程中感染、血细胞减少等不良反应发生率差异无统计学意义(P>0.05)。结论诱导化疗第14天存在明显残留病的急性髓系白血病患者采用小剂量预激方案早期再诱导化疗有较高的CR率,优于标准DA方案。

Objective To evaluate the remission situation of early re-induction with priming low dose regimen containing G- CSF in treating acute myeloid leukemia （AML）. Methods Ninety-seven AML patients in our hospital from March 2015 to January 2017 were retrospectively analyzed. All cases adopted the standard DA regimen for conducting the induction chemotherapy, among them, 38 cases had significant residual disease on 14 d of induction chemotherapy, 21 cases adopted the low dose priming regimen for conducting the early reqnduction chemotherapy, 17 cases adopted the tandard DA gregimen for conducting the re-induction chemo- therapy. The complete remission（CR） rate and and adverse reactions were compared between two groups. Results The total CR rate in all 97 cases was 60.8% ;among 38 cases needing re-induction chemotherapy,the CR rate in the priming regimen re-induction group was 76.2 %, which was significantly higher than 41.2 % in the DA regimen re-induction group, the difference was statistically significant （P= 0. 028）;the occurrence rates of side effects such as infection and cytopenia during re-induction chemotherapy process had no difference between two groups（P〉0.05）. Conclusion For AML patients with obvious residual disease on 14 d of induction chemotherapy,adopting low dose priming regimen in re-duction chemotherapy has higher CR, which is superior to the standard DA regimen.