不同剂量阿糖胞苷FLAG方案治疗难治、复发性急性髓系白血病的系统评价

目的:评价使用不同剂量阿糖胞苷(Ara-C)(即标准剂量(Ara-C1.0～2.0g/m-2.d-1)及小剂量(即改良剂量Ara-C0.2～0.5g/m-2.d-1))的FLAG方案治疗难治、复发性急性髓系白血病(AML)的临床疗效。方法:计算机检索1992～2010年5月Cochrane囱书馆、PubMed、EMbase及CBM数据库,收集不同剂量阿糖胞苷的FLAG方案治疗难治、复发性急性髓系白血病的随机对照试验(RCT)进行了系统评价。结果:8个随机对照试验共纳入329例患者,Meta分析结果显示:标准剂量阿糖胞苷的FLAG方案与小剂量阿糖胞苷的FLAG方案治疗难治、复发急性随性白血病的有效率没有统计学差异[RR1.45(0.81,2.61)]。结论:标准剂量阿糖胞苷FLAG方案治疗难治性急性髓系白血病在有效率方面没有比小剂量阿糖胞苷方案优越。由于纳入研究质量较低,需要高质量、大样本的随机、双盲对照试验加以证实。

Systemic Review on Different Dosages of FLAG Regimen in Treatment of Refractorylind Relapsed Acute Myeloid Leukemia(AMI)

Objective To compare the efficacy of standard(Ara-C 1.0-2.0 g/m-2.d-1)and improved(Ara-C0.2～0.5 g/m-2.d-1) FLAG regimenin treatment of refractory and relapsed AML.Method By Retrieving from Pub Med,Cochrane library,EMbase and CBM,identify randomized controlled trials(RCTs) which compared standard and improved FLAG regimen in treatment of refractory and relapsed AML.Result 8 RCTs were included in this study,with a total of 329patients.Meta-analysis showed that there was no difference in standard and improved FLAG regimen in treatment of refractory and relapsed AML[RR1.45(0.81,2.61)].Conclusion On the basis of these results,standard FLAG regimen was not superior to improved FLAG in treatment of refractory and relapsed AML.Large and high-quality RCTs are needed.