较高剂量柔红霉素诱导老年急性髓性白血病缓解的疗效分析

目的 探讨较高剂量柔红霉素(DNR)对诱导老年急性髓性白血病（AML）缓解及疗效的作用。方法 随机将123例老年AML分为三组，分别给予标准剂量、低于标准剂量和高于标准剂量的DNR，联合阿糖胞苷（Ara-c）作为首次诱导缓解方案，对比分析化疗产生的不良反应、完全缓解率和两年生存情况。结果 DNR高于标准剂量组血液学毒性反应的发生较标准剂量组未明显增加，而缓解所用时间短（P<0.01）、完全缓解率（63.4% vs 29.3%）和两年无事件生存率（58.5% vs 26.8%）提高（P值均<0.05）。结论 较高剂量DNR可作为诱导老年AML缓解较理想的选择。

Efficacy of higher-dose daunorubicin applied in induction-therapy for elder acute myeloid leukemia patients

Objective To investigate the remission and efficacy for higher-dose daunorubicin applied in induction-therapy for elder acute myeloid leukemia (AML) patients. Methods 123 elder patients with acute myeloid leukemia were chosen to be randomly assigned to receive first induction therapy including cytarabine, at a dose of 100 mg per day by continuous infusion for 7 days, plus daunorubicin for 3 days, at the conventional dose of 30 mg per square meter (41patients), at the conventional dose of 45 mg per square meter (41patients) and at an escalated dose of 60 mg per square meter (41 patients). The primary end point was two year event-free survival. Adverse reactions and complete remission rate were analyzed. Results In the higher- dose daunorubicin group, the complete remission time, rates and event-free survival were better than the conventional dose group (P < 0.05); There was no significant difference between the groups in the incidence of hematologic toxic effects. Conclusions Higher dose DNR can be optimal choice to induce elder AML to get remission.