CAT方案治疗难治性急性髓系白血病的临床观察

目的：初步观察CAT(环磷酰胺、阿糖胞苷、拓扑替康)方案对难治性急性髓系白血病(AML)的近期临床疗效并评价此方案的不良副作用。方法：选择8例难治性AML(原发难治性AML3例，AML伴多系形态发育异常，此前有MDS病史患者3例，慢性粒细胞白血病AML变2例)．应用CAT方案治疗，其中4例治疗1疗程，其余4例治疗2疗程。结果：1例在骨髓抑制期死于感染性休克．可评价疗效7例，1例达完全缓解(CR)，3例达部分缓解(PR)，1例CML急变患者经2疗程后回到慢性期，总有效率71．4％(5/7例)，中位生存期为6．5(0．3—22^ )个月。主要不良副作用为骨髓抑制。结论：CAT方案为高危MDS、加速／急变期CML和继发于MDS的AML患者的一个有效且毒性可耐受的治疗新方案。

TREATMENT OF REFRACTORY ACUTE LEUKEMIA WITH CYCLOPHOPHAMIDE,Ara- C AND TOPOTECAN(CAT) REGIMEN

Objective: To observe the effects and side- effects of cyclophosphamide,cytarabine,topotecan(CAT) combination regimen for the treatment of refractory acute myeloid leukemia(AML). Methods: 8 patients with refractory AML were treated with CAT chemotherapy,4 accepted 1 course, and the others accepted 2 courses. Results: One patient died of sepsis,the other seven patients,one patient achieved completely remission(CR), three patients achieved partial remission and one blastic crisis CML patient come back chronic phase. The total response rate is 71.4 %(5/7 cases). The major side- effect of CAT regimen was bone marrow suppression. Conclusion: The CAT regimen may be a effective and tolerable choice for patients with high risk MDS, AP/BC CML and MDS secondary AML.