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目的研究化疗联合微移植方案治疗难治及复发急性髓系白血病(acute myeloid leukemia,AML)的疗效。方法收集2014年2-8月在唐都医院血液内科采用化疗联合微移植方案诱导治疗的12例难治及复发急性髓系白血病患者,对治疗效果进行分析。结果 12例患者均完成1个疗程的化疗联合微移植,其中获得完全缓解3例,部分缓解3例,未缓解6例,有效率50%。达到完全缓解的3例中2例随后分别行二次微移植、异基因骨髓移植治疗,1例患者在第1次微移植后1个月时出现移植物抗宿主病(GVHD)导致死亡。部分缓解3例中2例行二次微移植治疗,仍未缓解,1例放弃治疗。6例未缓解中2例分别行二次微移植、异基因骨髓移植结果均未缓解,2例因并发症于院外死亡,2例放弃治疗。结论化疗联合微移植提高了难治、复发ANLL的缓解率,并且降低单纯化疗的毒性作用,是难治复发ANLL的较好的治疗手段。
Objective To study the efficacy of chemotherapy combined with micro-transplantation in the treatment of refractory and relapsed acute myeloid leukemia (AML). Methods Twelve patients with refractory or recurrent acute myeloid leukemia induced by chemotherapy combined with micro-transplantation were enrolled in Department of Hematology, Tangdu Hospital from February to August, 2014. The therapeutic effect was analyzed. Results All the 12 patients completed one course of chemotherapy combined with micro-transplantation. Among them, 3 patients achieved complete remission, 3 achieved partial remission, 6 had no remission, and the effective rate was 50%. Two of the three patients who achieved complete remission were treated with secondary micro-allograft and allogeneic bone marrow transplantation, and one patient developed graft-versus-host disease (GVHD) at one month after the first micro-transplant. Partial remission in 2 cases 2 cases of micro-transplantation, still untreated, 1 case to give up treatment. Two of the six cases were unresectable and the second micro-transplantation was performed respectively. None of the allogeneic bone marrow transplantation results were relieved. Two patients died of complications due to complications and two gave up treatment. Conclusions Chemotherapy combined with micro-transplantation can improve the refractory and relapsed ANLL remission rate and reduce the toxicity of chemotherapy alone. It is a good treatment for refractory relapsed ANLL.