氟达拉滨联合中剂量阿糖胞苷与高剂量阿糖胞苷作为急性髓系白血病巩固治疗的回顾性比较

Retrospective comparison of fludarabine in combination with intermediate-dose cytarabine versus high-dose cytarabine as consolidation therapies for acute myeloid leukemia.

作者信息

Zhang Wenjun, Ding Yi, Wu Hao, Chen Yuhua, Lu Huina, Chen Chunying, Fu Jianfei, Wang Weiguang, Liang Aibin, Zou Shanhua

机构信息

From the Department of Hematology, Tongji Hospital, Tongji University School of Medicine (WZ, YD, HW, YC, HL, CC, JF, AL); and Department of Hematology, Zhongshan Hospital, Fudan University (WW, SZ), Shanghai, China.

出版信息

Medicine (Baltimore). 2014 Dec;93(27):e134. doi: 10.1097/MD.0000000000000134.

This retrospective study compared efficacy and safety of fludarabine combined with intermediate-dose cytarabine (FA regimen) versus high-dose cytarabine (HiDAC regimen) as consolidation therapy in acute myeloid leukemia (AML) patients who achieved complete remission. Disease-free survival (DFS) and overall survival (OS) based on age (≥ 60, <60 years) and cytogenetics were evaluated from data between January 2005 and March 2013. Total 82 patients (FA, n = 45; HiDAC, n = 37; 14-65 years) were evaluated. Five-year DFS was 32.0% and 36.2% for FA and HiDAC groups, respectively (P = 0.729), and 5-year OS was 39.5% and 47.8% (P = 0.568), respectively. Among older patients (≥ 60 years), 3-year DFS was 26.0% for FA group and 12.5% for HiDAC group (P = 0.032), and 3-year OS was 34.6% and 12.5%, respectively (P = 0.026). In FA group, hematological toxicities were significantly lower. FA regimen was as effective as HiDAC regimen in patients with good/intermediate cytogenetics and significantly improved DFS and OS in older patients.

这项回顾性研究比较了氟达拉滨联合中剂量阿糖胞苷（FA方案）与高剂量阿糖胞苷（HiDAC方案）作为巩固治疗手段，用于急性髓系白血病（AML）完全缓解患者时的疗效和安全性。基于2005年1月至2013年3月的数据，评估了无病生存期（DFS）和总生存期（OS），并根据年龄（≥60岁、<60岁）和细胞遗传学进行分析。共评估了82例患者（FA组45例；HiDAC组37例；年龄14 - 65岁）。FA组和HiDAC组的5年DFS分别为32.0%和36.2%（P = 0.729），5年OS分别为39.5%和47.8%（P = 0.568）。在老年患者（≥60岁）中，FA组的3年DFS为26.0%，HiDAC组为12.5%（P = 0.032），3年OS分别为34.6%和12.5%（P = 0.026）。在FA组中，血液学毒性明显更低。FA方案在细胞遗传学良好/中等的患者中与HiDAC方案疗效相当，且在老年患者中显著改善了DFS和OS。