Cao Jin, Ye Yao-Zhen, Zheng Xiao-Yun, Chen Yi, Luo Lu-Ting, Zheng Jing, Yang Ting, Hu Jian-Da
Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Jun;31(3):671-676. doi: 10.19746/j.cnki.issn.1009-2137.2023.03.009.
To evaluate the efficacy and safety of idarubicin combined with high-dose cytarabine as a post-remission therapy for elderly patients with acute myeloid leukemia (AML).
From November 2017 to June 2021, 24 AML patients aged ≥60 years who were in complete remission for the first time were enrolled in consolidation chemotherapy with idarubicin (10 mg/m intravenously once for day 1) combined with high-dose cytarabine (1.5 g/m intravenously over 3 hours every 12 hours for day 1-3), and the efficacy and safety were observed.
Among the 24 patients, there were 12 males and 12 females, the median age was 65 (60-78) years old, and the median follow-up time was 23.3 (2-42.7) months. By the end of the follow-up, 15 patients relapsed and 11 patients died. The median disease-free survival (DFS) was 9 months and there were 3 cases of 2-year DFS. The median overall survival (OS) was 16.2 months, and there were 4 cases of 2-year OS. In terms of safety, 6 patients had grade 1-2 non-hematological adverse reactions, 12 patients had grade 3-4 hematological adverse reactions, and a total of 6 patients developed infection after consolidation chemotherapy. Multivariate analysis showed that two induction cycles and high-risk cytogenetic abnormalities were the adverse factors of DFS and OS in elderly patients with AML in this study.
For AML patients ≥60 years old in first complete remission, idarubicin combined with high-dose cytarabine as post-remission therapy has a better safety, but compared with other regimens does not improve the prognosis of elderly patients, which needs further exploration.
评估去甲柔红霉素联合大剂量阿糖胞苷作为老年急性髓系白血病（AML）患者缓解后治疗的疗效和安全性。
2017年11月至2021年6月，纳入24例年龄≥60岁首次完全缓解的AML患者进行巩固化疗，采用去甲柔红霉素（第1天静脉注射10mg/m，1次）联合大剂量阿糖胞苷（第1 - 3天，每12小时静脉注射1.5g/m，持续3小时），观察疗效和安全性。
24例患者中，男性12例，女性12例，中位年龄65（60 - 78）岁，中位随访时间23.3（2 - 42.7）个月。随访结束时，15例患者复发，11例患者死亡。中位无病生存期（DFS）为9个月，2年DFS有3例。中位总生存期（OS）为16.2个月，2年OS有4例。安全性方面，6例患者出现1 - 2级非血液学不良反应，12例患者出现3 - 4级血液学不良反应，巩固化疗后共有6例患者发生感染。多因素分析显示，两个诱导周期和高危细胞遗传学异常是本研究中老年AML患者DFS和OS的不良因素。
对于首次完全缓解的≥60岁AML患者，去甲柔红霉素联合大剂量阿糖胞苷作为缓解后治疗安全性较好，但与其他方案相比未改善老年患者预后，需进一步探索。
