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目的:观察循环应用CAG、IA方案治疗老年初治急性髓性白血病(AML)的疗效及不良反应。方法:25例老年初治AML患者分为CAG、IA循环化疗组(Ⅰ组)以及常规方案化疗组(Ⅱ组),Ⅰ组10例患者给予CAG方案治疗,如达不到完全缓解原方案再次治疗,完全缓解后给予IA方案化疗,间歇1个月后再循环应用CAG、IA方案化疗;Ⅱ组15例患者予常规柔红霉素(DNR)+阿糖胞苷(DA)或米托蒽醌+阿糖胞苷(MA)方案化疗,完全缓解后应用DA、MA、HA和IA等方案化疗。结果:Ⅰ组2个周期完全缓解率为60%(6/10),总有效率达到80%(8/10),而Ⅱ组2个周期的完全缓解率仅为26.7%(4/15),总有效率为53.3%(8/15);Ⅰ组无化疗相关死亡病例,Ⅱ组化疗相关死亡率为20%。结论:循环应用CAG、IA方案治疗老年初治AML患者较传统常规化疗方案治疗具有完全缓解率及2年生存率高,毒副反应小的优点。
Objective: To observe the curative effect and adverse reactions of recurrent CAG and IA regimen in the treatment of senile acute myeloid leukemia (AML). Methods: Twenty-five elderly patients with newly diagnosed AML were divided into two groups: CAG, IA chemotherapy (group Ⅰ) and conventional chemotherapy (group Ⅱ), and 10 patients in group Ⅰ were treated with CAG. If they failed to achieve complete remission, The patients in group Ⅱ were given chemotherapy regimen of CAG and IA. One patient in group Ⅱ was given conventional chemotherapy of daunorubicin (DNR) + cytarabine (DA) or mitoxantrone Quinone + cytarabine (MA) regimen chemotherapy, complete remission after the application of DA, MA, HA and IA regimen chemotherapy. Results: The complete remission rate was 60% (6/10) in 2 cycles and the total effective rate was 80% (8/10) in group Ⅰ. The complete remission rate in 2 cycles of group Ⅱ was only 26.7% (4/15) , With a total effective rate of 53.3% (8/15). There was no chemotherapy-related death in group Ⅰ, and the chemotherapy-related mortality in group Ⅱ was 20%. Conclusion: The CAG and IA regimens have the advantages of complete remission rate, high 2-year survival rate and small toxic side effects compared with conventional chemotherapy regimen in elderly patients with newly diagnosed AML.