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目的探讨难治、复发性白血病的治疗方法。方法用ＭＡ方案和ＩＤ－Ａｒａ－Ｃ方案治疗３４例成人难治性及复发性急性髓细胞性白血病（ＡＭＬ）。结果完全缓解（ＣＲ）率为３２．４％，有效率４１．２％；其中难治组ＣＲ率为２１．４％，复发组ＣＲ率为４０％（Ｐ＞０．０５）；ＭＡ方案组ＣＲ率为３７．５％；ＩＤ－Ａｒａ－Ｃ方案组ＣＲ率为２０％（Ｐ＞０．０５）。随访观察，取得ＣＲ的１１例病人，中位ＣＲ期为１２月（３～３２个月）；存活３年以上者１例（２．９％）。结论ＭＡ方案及ＩＤ－Ａｒａ－Ｃ方案对诱导成人难治及复发性ＡＭＬ的临床缓解有一定效果，但持续ＣＲ时间短，长期预后差，能长期生存的机会极微，仍需探索更好的治疗方法。
Objective To investigate the treatment of refractory and relapsed leukemia. Methods Thirty-four adult patients with refractory and relapsed acute myeloid leukemia (AML) were treated with MA regimen and ID-Ara-C regimen. Results The complete remission (CR) rate was 32.4% and the effective rate was 41.2%. The CR rate in the refractory group was 21.4%, and the CR rate in the relapse group was 40% (P>0.05); the MA program group The CR rate was 37.5%; the CR rate in the ID-Ara-C regimen group was 20% (P>0.05). Follow-up observations showed that 11 patients with CR had a median CR of 12 months (range, 3 to 32 months), and 1 patient (2.9%) had survived for more than 3 years. Conclusions The MA regimen and ID-Ara-C regimen have certain effects on the induction of clinical remission of refractory and relapsed AML in adults, but the duration of CR is short, the long-term prognosis is poor, and the chance of long-term survival is minimal. It is still necessary to explore better treatment method.