中剂量阿糖胞苷强化治疗老年急性髓系白血病疗效观察
郭智、谭晓华、陈惠仁、陈霞、刘晓东、楼金星、 何学鹏,北京军区总医院血液科,100700;阮新建、陈点点、王飞,肿瘤科
摘 要:目的 研究中剂量阿糖胞苷(0.5~1 g/m2)治疗老年急性髓系白血病(AML)患者的近期疗效及安全性。方法 应用中剂量阿糖胞苷治疗诱导化疗缓解后的8例老年AML患者,连续4~6个疗程。结果 全部患者均可耐受,有较好的安全性,随访至2009年8月,有5例为持续缓解状态,3例在停止治疗后复发进展而死亡。结论 中剂量阿糖胞苷治疗老年AML患者有较好的疗效,患者能够耐受且副作用少,值得更大规模的临床应用,可作为诱导化疗缓解后老年AML的一线巩固后续治疗方案,治疗4~6个疗程,克服了老年AML患者需要长时间反复化疗的缺点,提高了持续缓解时间,是老年AML患者长期无病生存的重要治疗方法。
关键词:白血病,髓样,急性; 阿糖胞苷; 老年人
参考文献:
[1] 林文远. 老年人急性髓性白血病的治疗现状. 中华老年医学杂志,2004,4(23):284-286.
[2] Mayer RJ,Davis RB,Schiffer CA,et al. Intensive postremission chemotherapy in adults with acute myeloid leukemia. Cancer and Leukemia Group B. Engl J Med,1994,331(14):896-903.[PubMed]
[3] Stone RM. The difficult problem of acute myeloid leukemia in the older adult. CA Cancer J Clin,2002,52(6):363-371.[PubMed]
[4] Whitlock JA,Wells RJ,Hord JD,et al. High-dose cytosine arabinoside and etoposide:an effective regimen without anthracyclines for refractory childhood acute non-lymphocytic leukemia. Leukemia,1997,11(2):185-189.[PubMed]
[5] Farag SS,Ruppert AS,Mrózek K,et al. Outcome of induction and postremission therapy in younger adults with acute myeloid leukemia with normal karyotype:a cancer and leukemia group B study. J Clin Oncol,2005,23(3):482-493.[PubMed]
[6] 杨科,何学鹏,唐晓东,等. 大剂量阿糖胞苷对急性髓细胞白血病缓解后治疗的无病生存影响. 中华内科杂志,1994,33(7):470-473.
[7] 郭智,刘晓东,谭晓华,等. 大剂量阿糖胞苷强化疗对急性髓性白血病长期生存的影响. 中国肿瘤临床与康复,2009,16(2):151-152.
[8] Böhm A,Piribauer M,Wimazal F,et al. High dose intermittent ARA-C(HiDAC)for consolidation of patients with de novo AML:a single center experience. Leuk Res,2005,29(6):609-615.[PubMed]
[9] Cole N,Gibson BE. High-dose cytosine arabinoside in the treatment of acute myeloid leukaemia. Blood Rev,1997,11(1):39-45.[PubMed]
[10] Herzig RH,Wolff SN,Lazarus HM,et al. High-dose cytosine arabinoside therapy for refractory leukemia. Blood,1983,62(2):361-369.[PubMed]
[11] Slovak ML,Kopecky KJ,Cassileth PA,et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia:a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood,2000,96(13):4075-4083.[PubMed]
期刊存档









