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目的:比较成人急性淋巴细胞白血病(ALL)患者不同疗程诱导化疗方案治疗的疗效。方法:回顾性分析2007-01-2013-12初治的ALL患者71例,采用SPSS19.0统计学软件分析有关数据。结果:1根据诱导缓解治疗方案分为改良短疗程方案、标准疗程方案2组,2组的1个疗程完全缓解率分别为78.8%和89.5%,复发率分别为42.4%和47.4%。2改良短疗程方案组中位总生存(OS)12(1~60)个月,中位无进展生存(DFS)9(0~59)个月;标准疗程方案组中位OS 12(1~74)个月,中位DFS 7(0~73)个月。2组的3年OS分别为27.6%和18.0%,3年DFS分别为17.8%和11.5%。3改良短疗程方案组及标准疗程方案组的粒细胞缺乏发生率分别为97.0%和100%,粒细胞缺乏持续时间分别为(10.7±2.4)d和(14.8±3.2)d。2组纤维蛋白原下降发生率分别为46.7%和41.7%,肝功能损害发生率分别为6.1%和10.5%。结论:2种方案在1个疗程完全缓解率、复发率、DFS和OS方面无差异,但诱导治疗采用改良短疗程方案较标准疗程方案不良反应少。
Objective: To compare the efficacy of different courses of induction chemotherapy regimen in adult patients with acute lymphoblastic leukemia (ALL). Methods: A retrospective analysis of 71 newly diagnosed ALL patients from January 2007 to December 2013 with SPSS19.0 statistical software was used to analyze the data. Results: 1 According to induction therapy, the short course of improvement was divided into two groups. The complete remission rate of one course of treatment was 78.8% and 89.5% respectively in two groups. The recurrence rates were 42.4% and 47.4% respectively. 2 The median overall survival (OS) was 12 (1-60) months with median progression-free survival (DFS) 9 (0-59) months in the modified short-course regimen; median OS 12 74) months, median DFS 7 (0-73) months. The 3-year OS in the 2 groups was 27.6% and 18.0%, respectively, and the 3-year DFS was 17.8% and 11.5%, respectively. The rates of agranulocytosis were 97.0% and 100% in the modified short-course and standard-treatment regimens, respectively. The duration of agranulocytosis was (10.7 ± 2.4) days and (14.8 ± 3.2) days, respectively. The incidences of fibrinogen decline in the two groups were 46.7% and 41.7%, respectively, and the incidence of hepatic impairment was 6.1% and 10.5%, respectively. Conclusion: There is no difference in complete remission rate, recurrence rate, DFS and OS between the two regimens in one regimen. However, the adverse effects of induction regimen with short regimen were less than those with standard regimen.