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目的探讨采用去甲氧柔红霉素(IDA)和HA方案[高三尖杉酯碱(HH)+阿糖胞苷(Ara-C)]方案双诱导治疗初治急性髓性白血病的临床效果及安全性。方法选取海南农垦总医院收治的初治急性髓性白血病80例,以随机数字表法随机分为对照组(40例)和观察组(40例);其中对照组患者采用IDA方案治疗,观察组患者则采用IDA与HA方案双诱导治疗。比较两组患者的临床疗效、中位总生存时间、复发率及不良反应发生情况等。结果两组患者临床疗效和中位总生存时间比较差异均无统计学意义(均P>0.05);观察组患者复发率(2.5%)显著低于对照组(20.0%),差异有统计学意义(P<0.05);两组患者骨髓抑制、消化道反应、出血及肝肾毒性的发生率比较差异均无统计学意义(均P>0.05);观察组患者心脏毒性的发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 IDA与HA方案双诱导治疗初治急性髓性白血病可有效降低心血管毒性的风险,提高治疗耐受性,且疗效与IDA方案相当。
Objective To investigate the clinical efficacy of dual induction therapy with drodiomatrine (IDA) and HA regimens [Homoharringtonine (HH) + cytarabine (Ara-C)] in the treatment of newly diagnosed acute myeloid leukemia. safety. Methods Eighty cases of newly diagnosed acute myeloid leukemia treated by General Hospital of Hainan Land Reclamation were randomly divided into control group (40 cases) and observation group (40 cases). The control group was treated with IDA protocol. Observation group Patients were treated with IDA and HA regimens. The clinical efficacy, median overall survival time, recurrence rate, and incidence of adverse reactions were compared between the two groups. Results There was no significant difference in clinical efficacy and median overall survival time between the two groups (all P>0.05). The recurrence rate in the observation group (2.5%) was significantly lower than that in the control group (20.0%). The difference was statistically significant. (P<0.05); There was no significant difference in the incidence of myelosuppression, gastrointestinal reaction, hemorrhage, and hepatic and renal toxicity between the two groups (all P>0.05); the incidence of cardiac toxicity was significantly lower in the observation group than in the control group. In the group, the difference was statistically significant (P<0.05). Conclusion IDA and HA regimen dual induction treatment for initial treatment of acute myeloid leukemia can effectively reduce the risk of cardiovascular toxicity and improve treatment tolerance, and the efficacy is comparable with the IDA protocol.