标准剂量去甲氧柔红霉素联合阿糖胞苷治疗急性髓细胞白血病

目的:探讨标准剂量的去甲氧柔红霉素(IDA)联合阿糖胞苷(Ara-C)治疗急性髓细胞白血病(AML)的疗效和不良反应。方法:14例AML患者,年龄13～70岁(中位年龄36岁),男8例,女6例。初治AML10例,难治、复发AML4例。所有患者均在治疗前进行染色体核型分析,4例染色体异常。诱导方案为IDA 12 mg·m-2·d-1,第1～3天,Ara-C 100 mg·m-2·d-1,持续静脉点滴,第1～7天。结果:1个疗程结束后总有效率92．9％(13／14),完全缓解率85．7％(12／14),其中初治AML的CR率为90．0％(9／10),复发、难治AML的CR率为75．0％(3／4),3例染色体异常患者达细胞遗传学缓解,未发生早期死亡。化疗的不良反应主要为骨髓抑制和粒细胞缺乏所致感染,未见严重的非造血系统不良反应。结论:标准剂量的IDA联合Ara-C 24 h持续静脉点滴,为初治、复发难治AML的高效、安全的方案。

Standard-dose idarubicin and continuous infusion cytarabine as induction therapy in patients with acute myeloid leukemia

Objective:To evaluate the efficacy and toxicity of standard-dose idarubicin and continuous infusion cytarabine as induction therapy in patients with acute myeloid leukemia (AML). Method: A total of fourteen AML patients were enrolled, including 10 patients with de novo AML, patients 4 relapsed and refractory AML. Eight patients were male, and 6 were female, with ages ranging from 13 to 70 years (median, 36 years). Cytogenetic a-nalysis was performed in all patients, and cytogenetic aberrations were found in 4 patients. All patients were treated with standard-dose idarubicin (12 mg/m2 , days 1 to 3) and continous infusion cytarabine (100 mg/m2 , days 1 to 7). Result: After one course of induction therapy, the overall response rate was 92. 9%, and 12 of 14 (85. 7%) patients achieved complete remission (CR), including 9 of 10 (90.9%) patients with de novo AML, 3 of 4 (75. 0%) patients with refractory and relapsed AML, 3 patients with cytogenetic aberrations achieved cytogenetic CR. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhema-tologic toxicity and the early death were not observed. Conclusion:Standard-dose idarubicin and continuous infusion cytarabine regimen as the induction therapy is high effective and well tolerable in patients with AML.