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目的观察氟达拉宾联合阿糖胞苷及粒细胞集落刺激因子(G-GSF,FLAG方案)治疗复发及难治性急性髓细胞白血病(AML)的临床疗效及安全性。方法对127例复发及难治性AML患者给予1～3个疗程FLAG方案化疗,观察其疗效及不良反应。结果难治性患者、早期复发及晚期复发患者的完全缓解(CR)率分别为44．2%(19/43例)、13．2%(5/38例)和73．9%(34/46例)。FLAG方案治疗1个疗程总体有效(OR)率[(CR率+部分缓解(PR)率]为62．2%(79/127例),多个疗程的OR率可达66．9%(85/127例)。阿糖胞苷日均剂量＜0．5g的21例患者中,CR率为9．5%(2例);而日均剂量为1．0～3．5g的106例患者中,CR率达52．4%(56例)。主要不良反应为骨髓抑制和继发感染。结论FLAG方案对于复发及难治性AML患者是一种有效的治疗选择,不良反应大多能够耐受。
Objective To observe the clinical efficacy and safety of fludarabine combined with cytarabine and granulocyte colony-stimulating factor (G-GSF, FLAG regimen) in the treatment of relapsed and refractory acute myeloid leukemia (AML). Methods A total of 127 patients with relapsed and refractory AML were treated with 1 ~ 3 cycles of FLAG regimen and their efficacy and adverse reactions were observed. Results In refractory patients, complete remission (CR) rates were 44.2% (19/43), 13.2% (5/38) and 73.9% (34 / 46 cases). The total effective rate (OR) of 1 course of treatment with FLAG regimen was 62.2% (79/127 cases), and the OR rate of multiple courses was 66.9% (85 / 127 cases), CR rate was 9.5% (2 cases) in 21 patients with average daily dose of cytarabine <0.5g, and 106 patients (average daily dose 1.0 ~ 3.5g) , CR rate was 52.4% (56 cases) .The main adverse reactions were myelosuppression and secondary infection.Conclusion The FLAG regimen is an effective treatment option for relapsed and refractory AML patients, and most of the adverse reactions are tolerated .