MAC方案在初始诱导失败急性髓系白血病患者治疗中的应用效果

Effect of MAC regimen on patients with acute myeloid leukemia after initial induction failure

目的探讨初始诱导失败急性髓系白血病(AML)患者应用米托蒽醌+环磷酰胺+阿糖胞苷(MAC)方案治疗的效果。方法抽取2018年5月至2021年5月平顶山市第二人民医院行MAC方案治疗且完成1年随访的初始诱导失败AML患者41例纳入观察组,另抽取同期行阿柔比星+阿糖胞苷+粒细胞集落刺激因子(CAG)方案治疗且完成1年随访的初始诱导失败AML患者41例纳入对照组。统计并比较两组治疗2个疗程结束时的治疗效果,统计并对比两组治疗前及治疗2个疗程结束时的血小板计数(Plt)、血红蛋白(Hb)水平;统计两组随访1年期间的生存时间,比较两组治疗期间不良反应发生情况。结果治疗2个疗程后,观察组治疗总缓解率(73.17%,30/41)高于对照组(51.22%,21/31),P<0.05。治疗2个疗程后,两组Plt、Hb水平均高于治疗前,且观察组Plt、Hb水平高于对照组(P<0.05)。绘制Kaplan-Meier生存曲线结果显示,对照组平均生存时间为12.00(9.50,12.00)个月,观察组为12.00(12.00,12.00)个月;用Log rank法检验患者生存时间,结果显示,观察组生存时间长于对照组(P<0.05)。治疗期间,两组恶心呕吐、腹泻、肾损伤及肝损伤发生率比较差异未见统计学意义(P>0.05)。结论MAC方案可提升初始诱导失败AML患者的治疗效果,延长生存时间,且未明显增加不良反应。

Objective To investigate the effect of mitoxantrone combined with cyclophosphamide and cytarabine(MAC)regimen on patients with acute myeloid leukemia(AML)after initial induction failure.Methods Forty-one AML patients with initial induction failure who were treated with MAC regimen and completed 1 year of follow-up in the Second People’s Hospital of Pingdingshan from May 2018 to May 2021 were selected and included as the observation group;and 41 AML patients with initial induction failure who were treated with adriamycin combined with cytarabine and granulocyte colony stimulating factor(CAG)regimen at the same time with 1 year of followed-up were selected and included into the control group.The therapeutic effect of the two groups at the end of two courses of treatment were counted and compared,the levels of platelet count(Plt)and hemoglobin(Hb)before treatment and at the end of two courses of treatment were counted and compared between the two groups;the survival time of the two groups during 1 year of follow-up was counted,and the adverse reactions during treatment were compared between the two groups.Results After 2 courses of treatment,the total remission rate of the observation group(73.17%,30/41)was higher than that of the control group(51.22%,21/31),P<0.05.After 2 courses of treatment,Plt and Hb levels of both groups were higher than those before treatment,and Plt and Hb levels of the observation group were higher than those of the control group(P<0.05).Results of Kaplan-Meier survival curve showed that,the average survival time of the control group was 12.00(9.50,12.00)months,and that of the observation group was 12.00(12.00,12.00)months.Log rank method was used to test the survival time of patients,the results showed that the survival time of the observation group was longer than that of the control group(P<0.05).During treatment,there was no significant difference in the incidence of nausea,vomiting,diarrhea,kidney injury and liver injury between the two groups(P>0.05).Conclusions MAC regimen can improve the therapeutic effect and prolong the survival time of patients with initial induction failure for AMI,and no adverse reaction increased.