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目的:评价VDCP与改良VDCP治疗急性淋巴细胞白血病的疗效。方法:38例急性淋巴细胞白血病患者按入院时间及患者意愿分为VDCP方案治疗组18例(24例次,A组)和改良VDCP方案治疗组20例(21例次,B组),对两组患者的完全缓解率(CR)、并发症、死亡率及各项费用进行比较。结果:改良VDCP组和VDCP组CR分别为61·9%和58·3%,中枢神经系统白血病发生率和病死率分别为15%、5·56%和20%、16·67%,两组CR、中枢神经系统白血病发生率及病死率比较差异均无显著性(P>0·05);改良VDCP组和VDCP组达CR中位时间分别为(26·8±9·2)d和(34·0±9·8)d,两组比较差异有显著性(P<0·05);改良VDCP组和VDCP组的白细胞最低值及持续时间分别为1·4×109·L-1、11·0d和0·75×109·L-1、15·4d,两组比较差异均有显著性(P<0·05);改良VDCP组和VDCP组药物费用及平均住院总费用分别为(5219·84±1985·46)元、(10603·70±3015·76)元和(7629·42±1525·36)元、(15040·92±4035·96)元,两组比较差异均有显著性(P<0·05)。结论:改良VDCP与VDCP方案治疗急性淋巴细胞白血病的完全缓解率和死亡率无明显差别,但改良VDCP较VDCP方案治疗达到CR的时间明显缩短,骨髓抑制轻,住院费用少。
Objective: To evaluate the efficacy of VDCP and modified VDCP in the treatment of acute lymphoblastic leukemia. Methods: Thirty-eight patients with acute lymphoblastic leukemia were divided into two groups according to the duration of admission and the wishes of the patients: VDCP regimen (18 cases in group A, 24 cases) and modified VDCP regimen in 20 cases (21 cases in group B) The patients’ complete remission (CR), complications, mortality and costs were compared. Results: The CR of VDCP group and VDCP group were 61.9% and 58.3%, respectively. The incidence of central nervous system leukemia and the mortality rate were 15%, 5.56% and 20%, 16.67% CR, the incidence of central nervous system leukemia and mortality were not significantly different (P> 0.05); the CR median time of modified VDCP group and VDCP group were (26.8 ± 9.2) d and ( 34 · 0 ± 9 · 8) d, the difference between the two groups was significant (P <0.05); the lowest and the last leukocyte in the VDCP group and the VDCP group were 1.4 × 109 · L-1, 11 · 0d and 0 · 75 × 109 · L-1, 15 · 4d, there was significant difference between the two groups (P <0.05); the cost of drug and the average hospitalization costs of VDCP group and VDCP group were ( 5219 · 84 ± 1985 · 46) yuan, (10603 · 70 ± 3015 · 76) yuan and (7629 · 42 ± 1525 · 36) yuan, (15040 · 92 ± 4035 · 96) yuan, the difference between the two groups was significant Sex (P <0.05). Conclusion: There is no significant difference in the complete remission rate and the mortality rate between the modified VDCP and VDCP regimens in the treatment of acute lymphoblastic leukemia. However, the time to achieve CR of the improved VDCP compared with the VDCP regimen is significantly shortened, the bone marrow suppression is light and the hospitalization cost is less.