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目的:观察改良CHG方案治疗初诊成人高白细胞性急性髓系白血病(HAML)的疗效及不良反应。方法:23例初诊成人HAML患者接受改良CHG方案化疗:高三尖杉酯碱(HHT)2 mg/d,静脉滴注;阿糖胞苷(Ara-C)10 mg/(m2·d),皮下注射,1次/12h,共14 d,化疗过程中,WBC<10×109/L时予粒细胞集落刺激因子(G-CSF)300μg/d,皮下注射,直至中性粒细胞绝对值(ANC)≥1.5×109/L时停用。结果:15例(65.2%)获得完全缓解(CR),2例(8.7%)部分缓解(PR),总有效率(OR)73.9%。早期死亡2例,病死率8.7%。WBC计数降至10×109/L以下所需时间为6(4~10)d。化疗期间主要不良反应为骨髓抑制,表现为粒细胞缺乏及继发感染、出血。结论:改良CHG方案治疗初诊成人高白细胞性急性髓系白血病有效率高,不良反应可控制。
Objective: To observe the curative effect and adverse reactions of modified CHG regimen in newly diagnosed adult patients with high white blood cell acute myeloid leukemia (HAML). Methods: Twenty-three newly diagnosed adult HAML patients underwent modified CHG regimen: homoharringtonine (HHT) 2 mg / d, intravenous drip; Ara-C 10 mg / (m2 · d) (G-CSF 300μg / d) was injected subcutaneously until neutrophil absolute value (ANC) during the course of chemotherapy with WBC <10 × 109 / L, once a week for 12 hours, ) ≥ 1.5 × 109 / L disabled. Results: Complete remission (CR) was achieved in 15 cases (65.2%), partial response (PR) in 2 cases (8.7%), and total effective rate (OR) 73.9%. Early death in 2 cases, the mortality rate of 8.7%. WBC count down to 10 × 109 / L the time required for the 6 (4 ~ 10) d. The main adverse reactions during chemotherapy were myelosuppression, manifested as agranulocytosis and secondary infection, bleeding. Conclusion: Modified CHG regimen is effective in treating newly diagnosed adult high leukocyte acute myeloid leukemia with controlled adverse reactions.