IAT与MAT化疗方案治疗难治和复发性急性髓系白血病的疗效观察

为了研究联合化疗提高难治复发急性髓系白血病(AML)患者治疗有效率,回顾分析99例难治和复发AML,其中难治性AML 56例,复发性AML 43例,分别给予伊达比星联合阿糖胞苷、替尼泊苷(IAT)方案28例和米托蒽醌联合阿糖胞苷、替尼泊苷(MAT)方案71例。结果表明:两组患者的总体有效率(OR)为65.7%,完全缓解(CR)率49.5%,部分缓解(PR)率16.2%。IAT组总有效率64.3%,CR率46.4%;MAT组总有效率66.2%,CR率50.7%,两组差异无统计学意义(P>0.05)。IAT组患者2年总生存率25%,MAT组患者2年总生存率15.5%。两组化疗患者中出现严重感染的分别为25%和9.9%。结论:IAT/MAT方案是难治和复发AML的有效治疗方案,两组CR率、总体有效率、无病生存率和总生存率无明显差异,两方案毒副作用患者可以耐受,本研究为患者争取移植机会和疾病长期存活奠定基础。

Effects of IAT and MAT chemotherapeutic regimens in patients with refractory or relapsed acute myeloid leukemia

The aim of this study was to investigate effects of IAT and MAT chemotherapeutic regimens treating patients with refractory and relapsed acute myeloid leukemia (AML). 99 patients with refractory and relapsed AML received IAT regimen or MAT regimen as study objects were retrospectively analyzed (56 patients with refractory AML and 43 patients with relapsed AML). Among of them, 28 patients were treated with IAT regimen, and 71patients received with MAT regimen. The results showed that in 2 groups mentioned above the OR was 65.7%, CR was 49.5%, PR was 16.2%; in IAT group the OR was 64.3%, CR was 46.4%; in MAT group the OR was 66.2%, CR was 50.7%, no statistical difference was found between these 2 groups; The 2 years overall survival was 25% in IAT group and 15.5% in MAT group. Serious infection in IAT and MAT regime groups was 25% and 9.9%, respectively. It is concluded that both IAT and MAT regimens are effective methods for inducing CR in patients with refractory of relapsed AML. IAT and MAT regimens can be used in treatment of the refractory or relapsed MAL patients who were not respond to other regimen.