化疗联合阿米福汀在急性髓性白血病中的病例对照研究

目的探讨阿米福汀在急性髓性白血病化疗中是否具有正常造血干细胞保护作用同时不造成复发率的升高。方法前瞻、非随机、病例对照研究142例急性髓性白血病巩固化疗患者血液学毒性及非血液学毒性、缓解率、缓解持续时间。结果阿米福汀联合化疗组56例男30例，女26例；高危18例，中危32例，低危6例；平均年龄（35．14±14．42）岁]，单独化疗组86例男58例，女28例；高危14例，中危64例，低危8例；平均年龄（46．58±16．99）岁]。两组间性别（P=0．318）、危险度（P=0．262）差异无统计学意义。年龄两组间有统计学意义（P=0．004），使用阿米福汀联合化疗组年轻患者多。阿米福汀联合化疗组中剂量阿糖胞苷联合组24例（42．9％），单独化疗组12例（14．9％）]以及HAA方案联合组18例（32．1％），单独化疗组18例（20．9％）]更多。阿米福汀联合化疗相较于单独使用化疗组，血小板〈20×109／L持续时间短联合组0（0，7）d，单独化疗组9（4，14）d，P=0．01）、输注血小板数少联合组0（0，3）U，单独化疗组4（1，6）U，P=0．02]。缓解率以及缓解持续时间两组差异无统计学意义，联合组化疗前缓解率为96．4％（54／56），化疗后缓解率仍为96．4％（54／56），单独化疗组1例治疗前未获得缓解的患者化疗后仍未缓解，化疗前缓解率为98．8％（85／86），化疗后仍为98．8％（85／86），两组间缓解率差值相比差异无统计学意义（P=0．062）。结论阿米福汀可用于急性髓性白血病化疗后的防护，血小板减少持续时间短，血小板输注减少，其他副作用未见明显差别。

A case-control study of therapy of amifostine plus chemotherapy on acute myeloid leukemia consolidation

Objective To investigate the protective effect of normal hematopoietic and without causing the increase of relapse rate of amifostine in patients with acute myeloid chemotherapy. Methods One hundred and forty-two acute myeloid leukemia（AML） patients were selected and divided into combination group （n = 56） and chemotherapy alone group （ n = 86 ）. Hematological toxicity and non-hematologic toxicity, response rate, duration of response of patients were prospective, non-randomized, case-control study. Results Fifty-six patients in combined group included 30 male and 26 female patients, and 18 patients in high risk stage and 32 patients in intermediate risk stage and 6 patients in low risk. The median age was （35.14 ± 14. 42） year in combination group. Chemotherapy alone group included 58 male 28 female patients, and 14 patients in high risk and 64 patients in intermediate risk and 8 patients in low risk. The median age was （46. 58 ± 16. 99 ）year. There were no significant difference between two groups in terms of gender （P = 0. 318） and risk stage（ P = 0. 262）. But more young patients were in combination group compared with chemotherapy alone group and there was significant difference（P =0. 004）. In combination group,42. 9% （24 cases） patients got high Ara-C dose and 32. 1% （ 18 cases） patients got high HAA dose chemotherapy compared with control group （14. 9% （12 cases）and 20. 9% （ 18 cases） ）. The during periods of platelet with 〈 20 x 109/L in combination was 0 （0,7）day, lower than that in chemotherapy alone group （9 （4,14）, P = 0. 01 ）. Meanwhile the volume of platelet infusion in combination group was less than that in chemotherapy alone group and the nadir of platelet4（0 （0,3） U vs. 4 （1,6） U, P = 0. 02 ） ~ No statistic difference was found in two groups regarding of non-hematological side effects and the relapse rate （ before and after treatment, combination group ：96.4% （ 54/56 ） ; Chemotherapy alone group ： 98.8% （ 85/86 ） ; P = 0. 062 ）. Conclusion Amifostine may provide protection for AML patients, can short duration of thrombocytopenia, reduce platelet transfusions, and other side effect was no significant difference.