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目的探讨难治性与复发性急性髓性白血病(AML)应用FLAG方案治疗的临床疗效及不良反应。方法采用FLAG方案:氟达拉滨(Flud)50mg/d静脉滴注,连用5d;阿糖胞苷(Ara-C)1 000mg/d,于Flud治疗后4h开始持续静脉滴注,连用5d;当中性粒细胞计数≤1.0×109/L时给予粒细胞集落刺激因子(G-CSF)5μg/(kg.d),皮下注射,直至WBC≥1.0×109/L。结果本组23例患者完全缓解9例,完全缓解率39.1%;部分缓解6例,部分缓解率26.1%,总有效率65.2%;未缓解6例,死亡2例。主要不良反应为消化道症状、骨髓抑制等。结论 FLAG方案治疗难治性与复发性急性髓性白血病疗效好,患者对其耐受性好。
Objective To investigate the clinical effects and adverse reactions of refractory and recurrent acute myeloid leukemia (AML) treated with FLAG regimen. Methods FLAG regimen: fludarabine (Flud) 50mg / d intravenous infusion, continuous use 5d; cytarabine (Ara-C) 1 000mg / d, Flud 4h after the start of continuous intravenous infusion for 5d; When the neutrophil count ≤ 1.0 × 109 / L granulocyte colony stimulating factor (G-CSF) 5μg / (kg.d), subcutaneous injection until WBC ≥ 1.0 × 109 / L. Results In this group of 23 patients, complete remission in 9 cases, complete remission rate was 39.1%; partial remission in 6 cases, partial remission rate was 26.1%, the total effective rate was 65.2%; 6 cases were not mitigated and 2 died. The main adverse reactions are gastrointestinal symptoms, bone marrow suppression and so on. Conclusion The FLAG regimen is effective in treating refractory and recurrent acute myeloid leukemia, and patients are well tolerated.