FLAG方案治疗难治性急性非淋巴细胞白血病的临床研究

 目的 评估FLAG方案对难治性急性非淋巴细胞白血病（ANLL）的疗效。方法 23例难治性ANLL患者采用FLAG方案治疗，氟达拉滨（Flud） 25 ~ 30 mg·m-2·d-1（50 mg／d），第1天至第5天，静脉滴注；阿糖胞苷（Ara-C）0.5 ~ 2 g·m-2·d-1第1天至第5天，静脉滴注；粒细胞集落刺激因子（G-CSF）300 μg／d，第0天至第5天或至中性粒细胞（ANC）计数≥0.5×109／L，皮下注射，连续治疗2个疗程以上评估疗效，并记录不良反应。疗效评价标准分为完全缓解（CR），部分缓解（PR），未缓解（NR）。结果 治疗总有效率73.91 %（17例），1个疗程CR率为52.17 %（12例），总的CR率为65.22 %（15例）。初发难治CR率85.71 %；晚期复发CR率87.5 %。结论 FLAG方案治疗难治性ANLL总体疗效较为满意，尤其对于初发难治和晚期复发患者，且毒副作用可以耐受，是治疗难治性白血病较为理想的方案。

The clinical study of FLAG regimen for refractory acute non-lymphocytic leukemia

Objective To study the efficacy and adverse effects of FLAG regimen (include fludara－bine,cytarabine and G-CSF) in the treatment of refractory acute non-lymphocytic leukemia. Methods 23 patients of refractory acute non-lymphocytic leukemia were treated with FLAG regimen. FLAG regimen was consisted of fludarabine(Flu, 25~30 mg·m-2·d-1，d1~5，vd),cytarabine( Ara-C 0.5~2 g·m-2·d-1, d1~5，vd), and G-CSF（ 300μg·d-1，d0~5 or until ANC count ≥0.5×109/L，sc）. The second course was given if complete re－sponse was not achieved. The clinical efficacy evaluation was divided into complete (CR), partial response (PR) and none response (NR). Results Total effective power was 73.91 %, and CR rates 65.22 %. The CR rates in one course was 52.17 %, CR rates in de novo refractory patients were 85.71 %, and 87.5 % in ad－vanced stage relapsing patients. Conclusion The outcome of FLAG regimen in the treatment of refractory a－cute non-lymphocytic leukemia was promising , especially for de novo refractory and advanced stage relapsing patients. And the adverse effects were acceptable. In a word, the FLAG regimen is an ideal regimen for re－fractory acute non-lymphocytic leukemia.