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含吡柔比星化疗方案治疗成人高危或难治复发急性白血病的疗效观察

[Therapeutic effects of chemotherapeutic regimens containing pirarubicin on the treatment of high-risk or refractory and relapsed acute leukemia in adults].

作者信息

Li Qun-hua, DU Xin, Huang Zi-lun, Luo Cheng-wei, Zhong Li-ye, Lin Wei

机构信息

Department of Hematology, Guangdong Provincial People's Hospital, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 May 11;85(17):1195-7.

Abstract

OBJECTIVE

To evaluate the therapeutic effects of chemotherapeutic regimen containing pirarubicin (THP) on the treatment of high-risk or refractory and relapsed acute leukemia (AL) in adults.

METHODS

Forty patients with high-risk or refractory and relapsed AL, 26 males and 14 females, aged 33 (14-63) received treatment regimens with THP: TA regimen [THP + cytosine-arabinoside (Ara-C)] for acute myeloid leukemia (AML) and TAOP regimen [THP + Ara-C + vincristine (VCR) + prednisone (Pred)] for acute lymphocytic leukemia (ALL) or biphenotype-AL. Forty matched patients received mitoxantron (MIT) + Ara-C for AML or MIT + Ara-C + VCR + Pred for ALL and biphenotype AL as controls. The therapeutic effects were observed.

RESULTS

The complete remission (CR) rate was 47.5% vs 45% (P > 0.05), partial response (PR) rate was 25% vs 20% (P > 0.05), and overall response (OR) rate was 72.5% vs 65% (P > 0.05) in the treatment group and control group. The continuous CR time was 528 days in the treatment group, significantly longer than in the control group (463 days, P < 0.05). Marrow suppression was more serious in the treatment group. The patients in the treatment group had higher incidence of infections (P < 0.05). The time with sustained recovery of platelet number was 13.9 days in the treatment group, significantly longer than in the control group (P < 0.05).

CONCLUSION

Regimens with THP are more effective on treatment of high-risk or refractory and relapsed AL in adults, however, with more serious marrow suppression and higher incidence of infection.

摘要

目的

评估含吡柔比星(THP)的化疗方案治疗成人高危或难治复发急性白血病(AL)的疗效。

方法

40例高危或难治复发AL患者,男26例,女14例,年龄33(14 - 63)岁,接受含THP的治疗方案:急性髓系白血病(AML)采用TA方案[THP + 阿糖胞苷(Ara - C)],急性淋巴细胞白血病(ALL)或双表型AL采用TAOP方案[THP + Ara - C + 长春新碱(VCR)+ 泼尼松(Pred)]。40例匹配患者接受米托蒽醌(MIT)+ Ara - C治疗AML,或MIT + Ara - C + VCR + Pred治疗ALL和双表型AL作为对照。观察疗效。

结果

治疗组与对照组的完全缓解(CR)率分别为47.5%和45%(P > 0.05),部分缓解(PR)率分别为25%和20%(P > 0.05),总缓解(OR)率分别为72.5%和65%(P > 0.05)。治疗组持续CR时间为528天,显著长于对照组(463天,P < 0.05)。治疗组骨髓抑制更严重。治疗组患者感染发生率更高(P < 0.05)。治疗组血小板计数持续恢复时间为13.9天,显著长于对照组(P < 0.05)。

结论

含THP的方案治疗成人高危或难治复发AL更有效,但骨髓抑制更严重,感染发生率更高。

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