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目的观察和评价小剂量MA方案治疗慢性粒细胞白血病(CML)急性髓系变的疗效和毒副作用,探讨其临床使用价值。方法12例CML急性髓系变采用小剂量MA方案,MTZ 5 mg,连用3d,Ara-C 100 mg连用7d,1~2个疗程有效者继续原方案巩固2个疗程后改为羟基脲联合α-2b干扰素维持治疗,同时给予对症支持治疗。结果5例1个疗程达PR,有效率41.7%,其中化疗第2个疗程后1例CR,生存9个月,1例持续PR生存5个月,3例转回慢性期,其中1例持续1年时再次急变,放弃治疗,2例持续慢性期至2007年底分别为9个月和11个月,仍存活。7例NR患者,2例诱导缓解时死于肺部感染,2例放弃,3例存活时间分别为4个月、5个月、7个月。结论对于那些没有经济能力进行Allo-HSCT或服用格列卫的CML急性髓系变患者,小剂量MA方案化疗是一个经济有效的方案。
Objective To observe and evaluate the efficacy and toxicities and side effects of low-dose MA regimen in the treatment of acute myeloid leukemia (CML) and explore its clinical value. Methods 12 cases of CML acute myeloid leukemia using low-dose MA regimen, MTZ 5 mg, with 3d, Ara-C 100 mg with 7d, 1 to 2 effective course of treatment to continue the original regimen to consolidate two courses changed to hydroxyurea combined with α -2b interferon maintenance therapy, symptomatic and supportive treatment. Results A course of 5 courses of PR was achieved with an effective rate of 41.7%. One course of CR after the second course of chemotherapy was 9 months. One case survived PR for 5 months and 3 cases returned to chronic stage, of which 1 continued 1 year again rapid change, to give up treatment, 2 cases continued to the end of 2007 were 9 months and 11 months, still alive. Of the 7 patients with NR, 2 died of pulmonary infection during induction remission, 2 gave up, and 3 survived for 4 months, 5 months and 7 months respectively. Conclusions Low-dose MA regimen chemotherapy is a cost-effective regimen for those patients with CML who are not financially viable for Allo-HSCT or taking Gleevec.