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低剂量阿糖胞苷方案对急性白血病和骨髓增生异常综合征/难治性贫血的疗效

[Effects of low dose Ara-C regimen in acute leukemias and RAEB].

作者信息

Kohno T, Nagai K, Tsukazaki K, Jinnai I, Tomonaga M, Ichimaru M, Tagawa M

出版信息

Rinsho Ketsueki. 1989 May;30(5):638-43.

PMID:2795877
Abstract

Recent increase of leukemia among elderly patients prompted us to investigate the types of leukemia which can be induced into remission by low-dose Ara-C (LDAC) regimen. LDAC regimen was performed in 30 cases with overt acute leukemia (A), hypoplastic leukemia (B), and RAEB (C); Group A consists of M1 (1 case), M2 (4 cases), M3 (1 case), M4 (4 cases), M6 (1 case), and ALL (2 cases), Group B AML (8 cases), ALL (2 cases), and null (1 case), Group C RAEB (2 cases), and RAEB-T (4 cases). Complete remission (CR) rate was 23% (3/13) in group A, 64% (7/11) in group B, 0% (0/6) in group C. Partial remission rate was 33% (2/6) in group C. In group A, patients with M2 were induced into CR. In group B, both AML and ALL were induced into CR. Hypocellular marrow indicating low leukemic burden related to good sensitivity to Ara-C. Duration of CR was rather short; mean duration being 5.3 months. In group C, 2 PR cases of RAEB showed partial hematological recovery. LDAC regimen is effective especially for most of hypoplastic leukemia and some of M2. Side effects were tolerable, but all CR cases passed through bone marrow hypoplasia and needed supportive cares.

摘要

老年患者白血病近期发病率的增加促使我们研究可通过低剂量阿糖胞苷(LDAC)方案诱导缓解的白血病类型。对30例显性急性白血病(A组)、低增生性白血病(B组)和难治性贫血伴原始细胞增多(RAEB,C组)患者实施了LDAC方案;A组包括M1(1例)、M2(4例)、M3(1例)、M4(4例)、M6(1例)和急性淋巴细胞白血病(ALL,2例),B组为急性髓系白血病(AML,8例)、ALL(2例)和无分类(1例),C组为RAEB(2例)和转化型RAEB(RAEB-T,4例)。A组完全缓解(CR)率为23%(3/13),B组为64%(7/11),C组为0%(0/6)。C组部分缓解率为33%(2/6)。在A组中,M2患者诱导获得CR。在B组中,AML和ALL均诱导获得CR。低细胞骨髓提示白血病负荷低,对阿糖胞苷敏感性高。CR持续时间较短;平均持续时间为5.3个月。在C组中,2例RAEB部分缓解病例出现部分血液学恢复。LDAC方案尤其对大多数低增生性白血病和部分M2有效。副作用可耐受,但所有CR病例均经历骨髓增生低下且需要支持治疗。

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