论文部分内容阅读
目的:探讨不同剂量阿糖胞苷对急性髓性白血病(AML)缓解后巩固治疗的疗效和安全性。方法:将62例经过诱导化疗取得完全缓解的AML患者,随机分为大剂量阿糖胞苷组(29例)和中剂量阿糖胞苷组(33例),在完全缓解后分别给予不同剂量的单药阿糖胞苷[2.0g/(m~2·次)及1.0~1.5g/(m~2·次),1次/12h,第1、3、5天],共6次为1个疗程,同组患者相同方案巩固4个疗程,随访12~48个月。结果:大剂量阿糖胞苷组1、2、3年的无复发生存率分别为93.8%、77.9%和56.8%,中剂量阿糖胞苷组1、2、3年的无复发生存率分别为83.5%、50.6%和23.1%,2组间比较差异有统计学意义(P<0.05);2组患者持续缓解时间差异无统计学意义;大剂量阿糖胞苷组患者的肺部感染发生率高于中剂量阿糖胞苷组,差异有统计学意义(55.2%∶36.4%,P<0.05)。结论:大剂量阿糖胞苷巩固治疗AML的疗效相比中剂量更有优势,在加强感染预防与治疗准备的前提下,值得进一步临床推广。
Objective: To investigate the efficacy and safety of different doses of cytarabine in the treatment of acute myeloid leukemia (AML) after consolidation therapy. Methods: Sixty-two AML patients with complete remission induced by induction chemotherapy were randomly divided into high dose cytarabine group (n = 29) and middle dose cytarabine group (n = 33). After complete remission, Of single drug cytarabine [2.0g / (m ~ 2 times) and 1.0 ~ 1.5g / (m ~ 2 times), 1 time / 12h, days 1,3,5 days], a total of 6 times 1 course of treatment, the same group of patients with the same program to consolidate 4 courses of treatment, followed up for 12 to 48 months. Results: The recurrence-free survival rates of high-dose cytarabine at 1, 2 and 3 years were 93.8%, 77.9% and 56.8% respectively. The recurrence-free survival rates at 1, 2 and 3 years in medium dose cytarabine group were Were 83.5%, 50.6% and 23.1%, respectively. The difference between the two groups was statistically significant (P <0.05). There was no significant difference in duration of sustained remission between the two groups. Pulmonary infection was observed in the high-dose cytarabine group The rate was higher than the medium dose of cytarabine group, the difference was statistically significant (55.2%: 36.4%, P <0.05). Conclusion: The effect of high-dose cytarabine in the treatment of AML is more advantageous than that of medium dose. Under the precondition of strengthening the prevention and treatment of infection, it is worth further clinical promotion.