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目的:比较预激方案与标准化学治疗(化疗)方案治疗初治急性髓系白血病(AML)的疗效、不良反应和生存情况。方法:回顾性分析175例可随访的初治AML患者,分成预激方案组(n=60)和标准方案组(n=115),标准方案组采用IA(去甲氧柔红霉素、阿糖胞苷)或DA(柔红霉素、阿糖胞苷),预激方案组采用CAG(阿克拉霉素、阿糖胞苷和粒细胞集落刺激因子)或IAG(去甲氧柔红霉素、阿糖胞苷和粒细胞集落刺激因子)诱导治疗,2组患者均为一疗程缓解,同方案巩固2个疗程,或2个疗程缓解,同方案巩固一疗程,随后进入巩固维持治疗阶段。结果:预激方案组与标准方案组在完全缓解率、无病生存率和总生存率方面差异无统计学意义(均P>0.05),但预激方案组患者化疗后骨髓恢复时间、感染发生率及单采血小板的输注量均低于标准方案组患者(均P<0.05)。结论:预激方案在治疗初治AML的临床疗效和患者生存情况与标准方案相类似,但骨髓抑制及感染发生等不良反应较标准方案轻微,故可作为初治AML患者诱导治疗的可选方案之一。
Objective: To compare the curative effect, side effects and survival of Acute Myeloid Leukemia (AML) treated with the pre-shock program and standard chemotherapy (chemotherapy) regimen. METHODS: A total of 175 patients with initially untreated AML were enrolled in this study. Patients were divided into two groups: the pre-shock group (n = 60) and the standard group (n = 115). The standard group received IA (daunorubicin, Cytarabine) or DA (daunorubicin, cytarabine) and the pre-challenged regimen group with CAG (aclacinomycin, cytarabine and granulocyte colony-stimulating factor) or IAG Cytosine and granulocyte colony-stimulating factor) induction therapy, two groups of patients were treated with a course of remission, with the program to consolidate two courses, or two courses of remission, with the program to consolidate a course of treatment, and then enter the consolidation of maintenance treatment stage . Results: There was no significant difference in complete remission rate, disease-free survival rate and overall survival rate between the pre-shock program group and the standard program group (all P> 0.05), but the bone marrow recovery time and infection occurred after chemotherapy The rates of transfusion and apheresis were lower than those of the standard regimen group (all P <0.05). Conclusions: The clinical efficacy and survival of patients with AML treated with the pre-shock program are similar to those of the standard regimen. However, adverse reactions such as myelosuppression and infection are mild compared with the standard regimen, so it can be used as an alternative to induction therapy for untreated AML patients one.