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目的观察3种方案诱导治疗急性粒细胞白血病部分分化型(M2型),单核细胞白血病(M5型)急性髓系白血病疗效。方法单中心回顾性分析62例住院患者资料,22例应用IA方案比较去甲氧柔红霉素+阿糖胞苷(IA)、柔红霉素+阿糖胞苷(DA)、米托蒽醌+阿糖胞苷(MA)3种诱导化疗方案治疗临床常见的M2型和M5型1疗程的临床疗效。,25例应用DA方案,15例应用MA方案。结果应用IA方案的患者1个疗程完全缓解(CR)18例,部分缓解(PR)2例,完全缓解率为81.8%,总有效率为90.9%;应用DA方案的患者1个疗程CR 14例,PR 5例,完全缓解率为56.0%,总有效率为76.0%;应用MA方案的患者1个疗程CR 7例,PR 2例,完全缓解率为46.7%,总有效率为60.0%.IA组1个疗程CR率及有效率较DA,MA组差异有统计学意义(P<0.05),DA,MA组差异无统计学意义(P>0.05)。3组化疗方案的血液学不良反应为骨髓抑制,IA组与其它两组比较,差异有统计学意义(P<0.05),DA,MA组比较,差异无统计学意义(P>0.05)。结论 IA,DA,MA方案均可有效诱导治疗M2,M5型急性髓系白血病,IA方案明显优于DA,MA方案,但其化疗后骨髓抑制较重,需要加强抗感染及输血支持治疗。
Objective To observe the curative effect of three kinds of regimens for the treatment of acute myeloid leukemia (M5) acute myeloid leukemia with partially differentiated (M2 type) and monocytic leukemia (M5). Methods Single-center retrospective analysis of 62 inpatient data, 22 cases of the application of IA regimen of methicillin-resistant daunorubicin + cytarabine (IA), daunorubicin + cytarabine (DA), mitoxantrone Quinone + cytarabine (MA) three kinds of induction chemotherapy regimen clinical common M2 and M5 type 1 course of clinical efficacy. , 25 patients with DA program and 15 patients with MA program. Results One course of complete remission (CR) was applied in 18 patients with partial remission (PR) in 2 patients, the complete remission rate was 81.8% and the total effective rate was 90.9% in patients receiving IA regimen. One course of CR in 14 patients with DA regimen , PR 5 cases, the complete remission rate was 56.0%, the total effective rate was 76.0%; patients with MA regimen CR treatment in 7 courses, PR 2 cases, the complete remission rate was 46.7%, the total effective rate was 60.0% .IA The CR rate and effective rate in one course of treatment were significantly different from those in DA and MA groups (P <0.05). There was no significant difference between DA and MA groups (P> 0.05). The hematologic adverse reactions of the 3 groups were bone marrow suppression. The difference between the IA group and the other two groups was statistically significant (P <0.05). There was no significant difference between the DA and MA groups (P> 0.05). Conclusions IA, DA and MA regimens are effective in inducing M2 and M5 acute myeloid leukemia. IA regimen is superior to DA and MA regimens. However, the regimens of bone marrow are more severe after chemotherapy, and anti-infective and blood transfusion support should be strengthened.