论文部分内容阅读
目的评估PrimingTherapy方案治疗复发、难治和继发性急性髓细胞白血病(AML)的疗效。方法予粒细胞集落刺激因子[(G-CSF,200μg/(m2·d),第1~14天,皮下注射)]、低剂量阿糖胞苷[(Ara-C,10mg/(m·d),d1~14,每12h皮下注射)]和阿克拉霉素[(A-cla,5~7mg/(m2·d),d1~8,静脉注射)]或高三尖杉酯碱[(HHT,1mg/(m·d),d1~8,静脉注射)]在内的PrimingTherapy方案治疗复发、难治及继发性AML患者25例。结果14例一个疗程CR,CR率56%,5例2个疗程CR,总有效率达76%,6例治疗无效,其中4例为复发病例,1例为标准常规化疗未取得缓解的病例,1例为老年低增生白血病,并可见粒细胞缺乏、血小板减少、继发感染及发热等不良反应。结论G-CSF可促进AML细胞的增殖和分化、增强化疗药物在细胞内的代谢及对白血病细胞的毒性作用,是本方案取得较高缓解率而毒副反应较少的理论基础。本方案治疗复发、难治和继发性急性髓细胞白血病安全有效。
Objective To evaluate the efficacy of PrimingTherapy in the treatment of relapsed, refractory and secondary acute myeloid leukemia (AML). Methods G-CSF (200μg / (m 2 · d), days 1 to 14, injected subcutaneously)], low-dose cytarabine [(Ara-C, 10mg / (m · d ), dl-14, subcutaneously every 12h) and acralomycin [(A-cla, 5-7 mg / (m2 · d), d1-8, iv)] or homoharringtonine [ , 1mg / (m · d), d1 ~ 8, intravenous injection)] in 25 patients with relapsed, refractory and secondary AML. Results A course of 14 cases of CR, CR rate of 56%, 5 cases of 2 courses of CR, the total effective rate was 76%, 6 cases of ineffective treatment, of which 4 cases of recurrence, 1 case of standard conventional chemotherapy did not get relief cases, 1 case of elderly hypo-leukemia, and shows agranulocytosis, thrombocytopenia, secondary infection and fever and other adverse reactions. Conclusion G-CSF can promote the proliferation and differentiation of AML cells and enhance the metabolism of chemotherapeutic drugs in the cells and the cytotoxic effect on leukemia cells, which is the theoretical basis for obtaining higher response rate and less toxic side effects. The treatment of relapsed, refractory and secondary acute myeloid leukemia safe and effective.