Hyper-CVAD方案治疗成人急性淋巴细胞白血病的疗效及安全性评价

目的 评价Hyper-CVAD方案治疗成人急性淋巴细胞白血病(ALL)的临床疗效及安全性.方法 将我院2006年1月至2009年6月初治的66例成人ALL患者中接受Hyper-CVAD方案的分为研究组(36例),接受常规化疗方案者为对照组(30例),通过比较2组完全缓解率和总生存率等参数,回顾性分析初发成人ALL患者接受Hyper-CVAD方案的疗效及毒副反应.结果 研究组与对照组的完全缓解率分别为86.1％ (31/36)和63.3％ (19/30),组间差异有统计学意义(P＜0.05)；性别、年龄、有无肝脾及淋巴结肿大、白细胞数量、血红蛋白水平、血小板数量、有无中枢神经系统受累、免疫分型及染色体核型对Hyper-CVAD方案的完全缓解率无明显影响.生存评估分析发现,研究组1、2、3年总生存率分别为88.9％(32例)、80.6％(29例)和66.7％(24例),而对照组分别为73.3％(22例)、63.3％(19例)和46.7％(14例),组间差异均有统计学意义(P＜0.05)；研究组中位生存时间为30.1个月(95％ CI:26.7～33.6),对照组为23.6个月(95％CI:24.5 ～30.2),组间差异有统计学意义(P＜0.05).2组患者诱导缓解期间的病死率及毒副反应发生率未见明显差异.结论 Hyper-CVAD方案治疗成人ALL疗效满意,安全性良好,毒副反应易于控制.

Efficacy and safety of Hyper-CVAD regimen for patients with adult acute lymphocytic leukemia

Objective To evaluate the clinical efficacy and safety of Hyper-CVAD regimen for patients with adult acute lymphocytic leukemia. Methods A total of 66 cases with adult acute lymphocytic leukemia were divided into treatment group treated with Hyper-CVAD regimen（ 36 cases）and control group treated with traditional chemotherapy regimen（30 cases）. The clinical efficacy and safety of the Hyper-CVAD regimen were observed. Results Compared with traditional chemotherapy, the complete response（CR） rate was significantly higher with Hyper-CVAD （P =0. 03） ： CR was 86. 1% in treatment group and it was 63.3% in control group. There was no evidence of sig- nificant association between CR rate in treatment group and gender, age, splenomegaly, hepatomegaly, lymphadenopathy, central nervous system involvement, .leukocytosis, immunophenotype and karyotype. During follow-ups, overall 1- ,2- and 3-year survival rates were 88.9% （32 cases） , 80. 6% （29 cases）and 66.7 % （24 cases）in treatment group versus 73.3% （22 cases） , 63.3% （ 19 cases） and 46. 7% （ 14 cases） in control group. The estimated mean OS （over survival）time of patients in treatment group was 30. 1 months （95 % CI： 26. 7-33. 6）and it was 23. 6 months （95% CI： 24. 5-30. 2）in control group （P 〈 0. 05 ）. The induction mortality rate and side effects showed no differences between treatment group and control group. Conclusions Hyper-CVAD regimen can be an optimistic therapy for patients with adult acute lymphocytic leukemia. Its side effects can be easily controlled.