HA联合替尼泊苷或表柔比星治疗急性髓系白血病疗效观察

Efficacy and safety of the HA regimen combined with teniposide or epirubicin as induction chemotherapy in acute myeloid leukemia

目的:探讨高三尖杉脂碱+阿糖胞苷联合替尼泊苷(HAT)或表柔比星(HAE)治疗急性髓系白血病(AML)的疗效及毒副反应。方法:回顾性分析了初治急性髓系白血病患者以HAT或HAE方案进行诱导化疗的疗效和毒性反应。统计完全缓解率(CR)及总生存(OS)率分析。结果:初治AML患者在HAT和HAE组一疗程诱导化疗CR率分别为90%和81%。两组中CR患者3年实际OS率分别为33.3%和53.8%。至随访结束HAT组无复发生存22.2%,HAE组30.7%。预期5年总生存率HAT组为20%,HAE组为44%。化疗相关的毒副反应主要为造血抑制和感染,患者可以耐受。结论:HA联合替尼泊苷或表柔比星诱导化疗疗效满意,不良反应可以耐受,可以作为一线诱导化疗方案。

Objective：To investigate the efficacy and safety of HA regimen combined with teniposide （HAT） or epirubicin （HAE） as induction chemotherapy in acute myeloid leukemia （AML）.Methods：De novo AML patients who accepted HAT or HAE regimen as induction chemotherapy were analyzed retrospectively.The complete remission （CR） rate of one course of chemotherapy was assayed.The overall survival rate,relapse free survival rate were also estimated.Results：After one course of HAT or HAE induction chemotherapy,the CR rate was 90% and 81% respectively.In patients who achieved CR,the actual 3 years OS rate is 33.3% in HAT group and 53.8% in HAE group.By the end of follow-up visit,the relapse free survival rate was 22.2% and 30.7% in HAT and HAE group respectively.The expected overall survival rate of 5 years is 20% and 44% respectively.The most common toxicities were myelosuppression and infection,which is tolerable to the patients.Conclusion：Using HA regimen combined with teniposide or epirubicin as induction chemotherapy for de novo AML achieved satisfactory efficacy without intolerable side effects.Both regimen can be used as first-line or consolidation chemotherapy to de novo AML.