伊达比星联合阿糖胞苷方案和米托葸醌依托泊苷联合阿糖胞苷方案治疗复发性急性白血病的疗效比较

目的：比较伊达比星(indarubicin)联合阿糖胞苷(cytarabine)(IA方案)和米托蒽醌(mitoxantrone)、依托泊苷(etoposide)联合阿糖胞苷(MEA方案)治疗复发性急性白血病的疗效。方法：将43例复发性急性白血病患者随机分为IA组(21例)和MEA组(22例)，分别应用IA方案或MEA方案进行治疗，比较两组的临床疗效及不良反应。结果：IA组、MEA组的完全缓解率分别为43％、50％，总有效率分别为52％、64％，两组差别无统计学意义。7例复发性急性粒—单核细胞性白血病患者应用MEA方案有4例得到完全缓解。两组均出现严重的骨髓抑制，两组出现的与化疗相关的其它不良反应差别无统计学意义。结论：用IA方案或MEA方案治疗复发性急性白血病均可取得满意的疗效，对急性粒—单核细胞性白血病可首选MEA方案，两种方案均可致严重的骨髓抑制，支持治疗显得很重要。

Comparison of IA and MEA regimens on relapsed acute leukemia

Objective:To compare the therapeutic effects of idarubicin plus cytarabine (IA) and mitoxantrone plus etoposide plus cytarabine (MEA) on relapsed acute leukemia. Methods:43 patients with relapsed acute leukemia were randomly divided into IA group (21 patients) and MEA group (22 patients). All patients were treated with IA or MEA. The results and adverse effects of the two regimens were compared. Results:Complete remission (CR) rate in IA and MEA groups was 43% and 50%,respectively. Total effective rate was 52% and 64%,respectively. The difference was not significant. Four out of seven patients in MEA group achieved CR. Severe bone marrow inhibition occurred in both groups,while other adverse effects relevant to chemotherapy were not significant. Conclusion:Satisfactory curative effect can be obtained with both IA and MEA regimens in relapsed acute leukemia. MEA regimen may be the first choice for the treatment of M4. Both regimens can result in severe bone marrow inhibition. Supporting therapy is very important.