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目的观察CAG预激方案(阿糖胞苷+阿克拉霉素+粒细胞集落刺激因子)治疗急性髓系白血病的临床疗效及不良反应。方法对急性髓系白血病患者35例实施CAG预激方案治疗,1个疗程即达完全缓解者,采用原方案巩固1个疗程,再采用DA、MA等方案交替巩固治疗,连续2个疗程仍未达完全缓解者停止该方案治疗。治疗过程中常规给予止吐、水化、碱化、预防感染等治疗。结果 1个疗程后,35例患者中完全缓解14例,部分缓解10例,未缓解11例,总有效率为68.57%(24/35)。15例初治患者总有效率为93.33%(14/15),20例复发、难治性患者总有效率为50%(10/20)。35例患者均出现Ⅳ级骨髓抑制,非血液系统不良反应主要包括胃肠道反应、口腔不良反应及感染等。随访期间,与治疗相关死亡病例共5例,非治疗相关死亡8例。结论 CAG方案治疗急性髓系白血病疗效满意,初治患者疗效优于复发、难治性患者,非血液系统不良反应发生率低。
Objective To observe the clinical efficacy and adverse reactions of CAG pre-stimulation regimen (cytarabine + aclacinomycin + granulocyte colony stimulating factor) in the treatment of acute myeloid leukemia. Methods 35 cases of acute myeloid leukemia patients underwent CAG preclinical regimen, one course of remission was complete remission, the use of the original regimen to consolidate a course of treatment, and then use DA, MA and other programs to alternately consolidate the treatment of two consecutive courses have not yet Complete remission to stop the program treatment. In the course of treatment routine given antiemetic, hydration, alkalization, prevention of infection and other treatment. Results After a course of treatment, of the 35 patients, 14 were completely relieved, 10 were partly relieved, and 11 were not relieved. The total effective rate was 68.57% (24/35). The total effective rate was 93.33% (14/15) in 15 newly diagnosed patients and 50% (10/20) in 20 relapsed and refractory patients. Grade IV myelosuppression was observed in 35 patients. Adverse reactions to non-hematologic malignancies included gastrointestinal reactions, oral adverse reactions and infections. During follow-up, there were 5 death-related deaths and 8 non-treatment-related deaths. Conclusion CAG regimen is effective in treating acute myeloid leukemia. The efficacy of CAG regimen is better than recurrent and refractory patients, and the incidence of adverse reactions in non-hematological system is low.