CAG方案治疗中高危骨髓增生异常综合征和急性髓系白血病的疗效观察

目的:观察阿糖胞苷、阿克拉霉素和粒细胞集落刺激因子联合方案(CAG方案)治疗中、高危骨髓增生异常综合征(MDS)和老年初治、难治、复发和继发于MDS的急性髓系白血病(AML)的临床疗效及不良反应。方法:应用CAG方案治疗MDS9例和AML23例,完成1个疗程后评估疗效,治疗失败患者则退出观察,有效者继续接受1个疗程治疗。结果:9例MDS临床均有效,其中完全缓解4例(44.4%)。部分缓解3例(33.3%),血液学进步伴骨髓缓解1例(11.1%),骨髓缓解1例(11.1%)。AML临床总有效13例(56.5%),其中完全缓解9例(39.1%),部分缓解4例(17.4%)。大部分患者出现了可以耐受的轻微不良反应,主要表现为骨髓抑制。结论:CAG治疗中、高危MDS和预后差的AML安全有效,长期疗效需进一步观察。

The outcome of CAG regiment for the treatment of middle and high risk myelodysplastic syndrome and acute myeloid leukemia

Objective:To observe the efficacy and adverse events of treatment for middle and high risk myelodysplastic syndrome(MDS),previously untreated elderly acute myeloid leukemia(AML),refractory AMI/relapsed AML and secondary AML from MDS with CAG regiment.Method:CAG regiment were used to treat 9 cases myelodysplastic syndrome and 23 cases acute myeloid leukemia.The outcome was evaluated after 1 course of treatment.The patients for whom treatment has failed were exited from the trial and the responders continued to receive another course of treatment.Result:For patients with MDS,4(44.4%)cases achieved completely remission(CR),3(33.3%)cases achieved partial remission(PR),1(11.1%)case achieved hematologic improvement(HI)and bone marrow completely remission(MCR),1(11.1%)case MCR.For patients with AML,The total responsive rate was 56.5%.Nine cases(39.1%)cases achieved CR,and 4(17.4%)cases achieved PR.Most of the cases had slight adverse events which mainly were marrow inhibition and could be tolerated.Conclusion:Treatment for middle and high risk MDS and unfavourable prognosis AML with CAG regiment is safe and effective.Long-term outcome need to be observed further.