FLAG与MEA方案治疗复发、难治成年人急性髓系白血病的临床观察

 【摘要】　目的　观察FLAG与MEA方案治疗复发、难治成年人急性髓细胞白血病（AML）的疗效及不良反应。方法　回顾性分析51例复发、难治成年AML（M3除外）患者的临床资料，按化疗方案分为FLAG组（23例）、MEA组（28例），观察两组的疗效及不良反应。结果　FLAG组完全缓解（CR）7例（30.4 %），部分缓解（PR）4例（17.4 %），有效率为47.8 %（11／23）；MEA组CR 10例（35.7 %），PR 6例（21.4 %），有效率为57.1 %（16／28），两组有效率比较差异无统计学意义（χ2＝0.443，P＞0.05）。两组均出现IV度骨髓抑制，继发感染率、出血发生率差异无统计学意义95.7 %（22／23）比89.3 %（25／28），82.6 %（19／23）比85.7 ％（24／28），均P＞0.05]。两组心脏毒性比较差异有统计学意义（χ2＝4.554，P＝0.042）。结论　FLAG方案治疗复发、难治成年人AML的疗效与MEA方案疗效相近，心脏毒性低，不良反应可耐受，可作为复发、难治AML的一线治疗方案。

Clinical study on FLAG and MEA regimen for refractory or relapsed adult acute myeloid leukemia

Objective To investigate the therapeutic effects and side effects of FLAG and MEA regimen in the treatment of relapsed and refractory adult acute myeloid leukemia. Methods Use retrospective analysis to Observe the therapeutic effects and side effects of the 51 cases of relapsed and refractory adult acute myeloid leukemia （M3 except） from January 2009 to June 2012 in our hospital, which： are divided into FLAG group （23 cases） and MEA group （28 cases） according to chemotherapy. Results In FLAG group,the rate of complete remission was 30.4 % （7/23）, the rate of partial remission was 17.4 % （4/23）, the effective rate was 47.8 % （11/23）. In MEA group, the rate of complete remission was 35.7 % （10/28）, the rate of partial remission was 21.4 % （6/28）, the effective rate was 57.1% （16/28）, difference between two groups was not statistically significant. Both groups appeared 1V degrees myelosupression,and there were no significant differences between them on incidences of secondary infection 95.7 % （22/23） vs 89.3 % （25/28）] and haemorrhagia 82.6 % （19/23） vs 85.7 % （24/28）]. Difference on cardiac toxicity was statistically significant. Conclusions Compared with MEA regimen, FLAG regimen are similar effective and can be well tolerated, which has lower cardiac toxicity. Thus, FLAG regimen can be used as first-line treatment for relapsed and refractory adult acute myeloid leukemia.