两种诱导化疗方案治疗急性髓系白血病的疗效比较

目的 比较两种诱导化疗方法对急性髓系白血病(AML)的治疗效果及预后.方法 32例确诊AML患者,其中15例患者采用方案1(阿糖胞苷、柔红霉素、依托泊苷和鞘内注射阿糖胞苷)和17例患者采用方案2(阿糖胞苷、伊达比星、依托泊苷、米托蒽醌和鞘内注射阿糖胞苷)诱导化疗2个疗程后,比较疗效及治疗前后血清血管内皮生长因子(sVEGF)水平.结果 方案2治疗AML的完全缓解率82.4％,高于方案1的80.0％ (P＜0.05)；患者经两种诱导化疗治疗后sVEGF水平较化疗前均明显下降,方案2较方案1更明显[分别为(97.7±10.8)、(106.9±10.6) ng/L] (P ＜0.05).结论 阿糖胞苷、伊达比星、依托泊苷、米托蒽醌、阿糖胞苷联合治疗AML疗效较好,推荐临床使用.sVEGF可作为AML治疗及预后的判断指标.

Compare the effects of daunorubicin,idarubicin and mitoxantrone in treatment patients with ALM

Objective To compare the effects of two different chemotherapies in treatment acute myeloid leukemia（ALM） patients. Methods sVEGF concentration was measured by ELISA in 32 AML patients. Section one, 15 patients, combined with Ara-C, daunorubicin, etoposide and intratheeal Ara-C. Section two, 17 patients, consisted of a combination of Ara-C, idarubicin, etoposide, mitoxantrone and intrathecal Ara-C. Results sVEGF level was significantly increased in newly diagnosed AML. The level of sVEGF in AML after 2 cycles of standard chemotherapy was significantly lower than newly diagnosed cases, but the effect of section two was much better compared with section one. Compared with the section one, the complete remission rate of section 2 was 82. 4% （P 〈 0. 05 ）. Conclusion sVEGF as a proangiogenesis factor was significantly increased in serum with AML. The level of sVEGF in patients with AML obtained therrnotherapy was significantly lower than that of pre-treating AML ones. VEGF should play a very important role in the leukemogenic process. The section two therapy should be used clinically.