大剂量阿糖胞苷强化治疗急性髓性白血病的疗效观察

目的探讨大剂量阿糖胞苷强化治疗急性髓性白血病的临床疗效。方法将我院2002年6月至2005年6月收治的40例急性髓性白血病患者随机分为强化治疗组和对照组，两组均以DA、HA或DAE方案诱导至完全缓解，巩固后强化治疗组采用大剂量阿糖胞苷静脉滴注治疗3个疗程，对照组不采用阿糖胞苷治疗，比较两组患者强化治疗后1年、3年、5年的无病生存情况，不良反应发生率和总治疗有效率。结果强化治疗组在1年、3年、5年内的无病生存率分别为85．0％（17／20）、60．0％（12／20）、30．0％（6／20）；对照组在1年、3年、5年内的无病生存率分别为20．0％（4／20）、50％（10／20）、0；强化治疗组1年、3年、5年内的无病生存率均显著高于对照组（P〈0．05）。强化治疗组治疗总有效率为85％，显著高于对照组（P〈0．05）。两组之间不良反应的发生率无显著统计学差异（P〉0．05）。结论采用大剂量阿糖胞苷强化治疗能显著提高急性髓性白血病患者化疗后1年、3年、5年内的无病生存率，远期疗效好，可作为急性髓性白血病缓解后的强化治疗药物。

The therapeutic effect of high-dose Ara-C based intensive therapy on acute myeloblastic leukemia

Objective To study the curative effect of high dose cytosine arabinoside（HD-Ara-C） intensive therapy on acute myeloid leukemia patients. Method 40 patients with acute myeloid leukemia from June 2002 to June 2005 were divided into the control group and the intensive therapy group randomly. All the patients were induced to complete remission with HA, DA or DAE program, and then they were treated with or without HD- Ara-C for 3 courses by intravenous drip after consolidation therapy. Disease-free survival（l）FS） at l, 3, 5 year after treatment were compared between the two groups. Results The DFS of intensive therapy group at l, 3, 5 year were 85.0%（17/20）, 60.0%（12/20）, 30.0%（6/20）, and the control group were 20.0%（4/20）, 50%（10/20）, 0, the DFS of intensive therapy group at 1, 3, 5 year were all significantly higher than the control group（P〈0.05）. The total effective rate of intensive therapy group was 85%, and it was higher than the control group（P〈0.05）. No significant difference was found of the incidence of the adverse effects between the two groups（P〉0.05）. Conclusion In- tensive therapy with HD-Ara-C signifieandy increased the DFS of acute myeloid leukemia patients at 1, 3, 5 year after chemotherapy, it could be used as a kind of intensive therapy drug for acute myeloid leukemia.