去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的疗效及安全性分析
|
摘要
目的探讨去甲氧柔红霉素(IDA)联合阿糖胞苷(Ara-C)治疗初发急性髓系白血病(AML)的疗效及安全性。方法选取我院血液科2015年5月—2018年5月收治的AML 60例为研究对象,根据化疗方案不同分为DA组32例和IA组28例。DA组采取柔红霉素(DNR)+Ara-C化疗,IA组采取IDA+Ara-C化疗;治疗1个疗程后观察2组的疗效和不良反应。结果 IA组完全缓解(CR)的病例数和CR+部分缓解(PR)的百分率高于DA组(P<0.05);2组化疗后血液毒副作用和非血液毒副作用比较差异无统计学意义(P>0.05)。结论 IDA联合Ara-C治疗初发AML安全、有效。
Objective To investigate curative effect and safety of Idamycin(IDA) combined with Cytarabine(Ara-C) in treatment of patients with newly acute myeloid leukemia(AML). Methods A total of 60 patients with AML admitted during May 2015 and May 2018 were divided into DA group(n=32) and IA group(n=28) according to different chemotherapy methods. DA group was treated with Daunorubicin(DNR) and Ara-C chemotherapy, while IA group was treated with IDA and Ara-C chemotherapy. Therapeutic effects and adverse reactions were observed after one course of treatment in two groups. Results Numbers of complete remission(CR) cases and percentage of CR+ partial remission(PR) in DA group were significantly higher than those in DA group(P<0.05). There were no significant differences in blood and non-blood toxic and side-effects after treatment between two groups(P>0.05). Conclusion IDA combined with Ara-C is safe and effective in treatment of patients with newly acute myeloid leukemia.
Objective To investigate curative effect and safety of Idamycin(IDA) combined with Cytarabine(Ara-C) in treatment of patients with newly acute myeloid leukemia(AML). Methods A total of 60 patients with AML admitted during May 2015 and May 2018 were divided into DA group(n=32) and IA group(n=28) according to different chemotherapy methods. DA group was treated with Daunorubicin(DNR) and Ara-C chemotherapy, while IA group was treated with IDA and Ara-C chemotherapy. Therapeutic effects and adverse reactions were observed after one course of treatment in two groups. Results Numbers of complete remission(CR) cases and percentage of CR+ partial remission(PR) in DA group were significantly higher than those in DA group(P<0.05). There were no significant differences in blood and non-blood toxic and side-effects after treatment between two groups(P>0.05). Conclusion IDA combined with Ara-C is safe and effective in treatment of patients with newly acute myeloid leukemia.
引文
[1]Rubnitz J E,Gibson BSmith F O.Acute myeloid leukemia[J].Hematology/oncology Clinics of North America,2010,24(1):35-63.
[2]曾慧敏,郭晔,竺晓凡.t(8;21)急性髓系白血病发病机制的研究进展[J].中国实验血液学杂志,2010,18(6):1632-1637.
[3]成慧娟.中国西北地区急性髓系白血病预后的流行病学研究[D].第四军医大学,2016:1-59.
[4]徐英辉,崔久嵬,李薇,等.急性髓系白血病细胞遗传学特征与诱导治疗反应的相关性分析[J].白血病·淋巴瘤,2013,22(4):206-208.
[5]郭青,刘欣,王兴兵,等.IA与DA化疗方案诱导治疗急性髓细胞白血病的疗效及安全性比较[J].山东医药,2016,56(25):97-99.
[6]中华医学会血液学分会白血病淋巴瘤学组.成人急性髓系白血病(非急性早幼粒细胞白血病)中国诊疗指南(2017年版)[J].中华血液学杂志,2017,38(3):177-182.
[7]张之南,沈悌.血液病诊断及疗效标准[M].北京:科学出版社,2007:131-132.
[8]Heerema-Mckenney A,Arber D A.Acute myeloid leukemia[J].Hematology/oncology Clinics of North America,2009,23(4):633-654.
[9]张瑞东,王林娅,郑胡镛.世界卫生组织2016急性白血病分型解读[J].中华儿科杂志,2017,55(1):15-18.
[10]程平,张东华.成人高危急性髓系白血病的治疗进展[J].临床血液学杂志,2015,28(2):259-264.
[11]朱世为,廖东,刘陶文.成人急性髓系白血病的治疗现状[J].实用肿瘤杂志,2013,28(4):347-351.
[12]杨璐璐,刘欣,李庆,等.急性髓系白血病免疫分型特点及与疗效相关性分析[J].中国实验血液学杂志,2014,22(1):1-5.
[13]何海涛,李惠民.急性髓系白血病靶向治疗的研究进展[J].中国实验血液学杂志,2016,24(1):245-249.
[14]韩艳霞.吡柔比星治疗难治及复发性恶性血液病的临床效果和不良反应[J].中国医药,2018,13(7):1052-1055.
[15]Ohtake S,Miyawaki S,Fujita H,et al.Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia:the JALSGAML201 Study[J].Blood,2011,117(8):2358-2365.
[16]Horton T M,Perentesis J P,Gamis A S,et al.A Phase2 study of bortezomib combined with either idarubicin/cytarabine or cytarabine/etoposide in children with relapsed,refractory or secondary acute myeloid leukemia:a report from the Children's Oncology Group[J].Pediatr Blood Cancer,2015,61(10):1754-1760.
[17]朱齐兵,陈慧君,唐小万,等.急性白血病患者化疗后血流感染病原菌分布及危险因素分析[J].中国医药,2018,13(1):104-107.
[18]Sekine L,Morais V D,Lima K M,et al.Conventional and high-dose daunorubicin and idarubicin in acute myeloid leukaemia remission induction treatment:a mixed treatment comparison meta-analysis of 7258 patients[J].Hematol Oncol,2016,33(4):212-219.
[19]Kantarjian H,O'Brien S,Jabbour E,et al.Effectiveness of homoharringtonine(omacetaxine mepesuccinate)for treatment of acute myeloid leukemia:a meta-analysis of Chinese studies[J].Clin Lymphoma Myeloma Leuk,2015,15(1):13-21.
[20]李婷婷,孙雪冬,董征,等.FLT3-ITD阳性与阴性急性髓细胞白血病的实验室特征及预后比较[J].解放军医学杂志,2013,38(6):501-505.
[21]胡琴,刘维,邵宏.药物性肝损伤的药物治疗研究进展[J].中国临床药理学与治疗学,2016,21(2):231-236.
[22]毕磊,曹丹阳,郭智.恶性血液病患者蒽环类药物化疗期间心电图异常分析[J].中国循证心血管医学杂志,2017,9(11):1354-1356.
[23]何吉琼.急性髓系白血病应用去甲氧柔红霉素及柔红霉素的诱导治疗研究[J].临床医学研究与实践,2016,1(16):30,32.
[24]胡文广.急性髓系白血病应用去甲氧柔红霉素及柔红霉素的诱导治疗研究[J].中国医药科学,2015,5(3):117-118,121.
[2]曾慧敏,郭晔,竺晓凡.t(8;21)急性髓系白血病发病机制的研究进展[J].中国实验血液学杂志,2010,18(6):1632-1637.
[3]成慧娟.中国西北地区急性髓系白血病预后的流行病学研究[D].第四军医大学,2016:1-59.
[4]徐英辉,崔久嵬,李薇,等.急性髓系白血病细胞遗传学特征与诱导治疗反应的相关性分析[J].白血病·淋巴瘤,2013,22(4):206-208.
[5]郭青,刘欣,王兴兵,等.IA与DA化疗方案诱导治疗急性髓细胞白血病的疗效及安全性比较[J].山东医药,2016,56(25):97-99.
[6]中华医学会血液学分会白血病淋巴瘤学组.成人急性髓系白血病(非急性早幼粒细胞白血病)中国诊疗指南(2017年版)[J].中华血液学杂志,2017,38(3):177-182.
[7]张之南,沈悌.血液病诊断及疗效标准[M].北京:科学出版社,2007:131-132.
[8]Heerema-Mckenney A,Arber D A.Acute myeloid leukemia[J].Hematology/oncology Clinics of North America,2009,23(4):633-654.
[9]张瑞东,王林娅,郑胡镛.世界卫生组织2016急性白血病分型解读[J].中华儿科杂志,2017,55(1):15-18.
[10]程平,张东华.成人高危急性髓系白血病的治疗进展[J].临床血液学杂志,2015,28(2):259-264.
[11]朱世为,廖东,刘陶文.成人急性髓系白血病的治疗现状[J].实用肿瘤杂志,2013,28(4):347-351.
[12]杨璐璐,刘欣,李庆,等.急性髓系白血病免疫分型特点及与疗效相关性分析[J].中国实验血液学杂志,2014,22(1):1-5.
[13]何海涛,李惠民.急性髓系白血病靶向治疗的研究进展[J].中国实验血液学杂志,2016,24(1):245-249.
[14]韩艳霞.吡柔比星治疗难治及复发性恶性血液病的临床效果和不良反应[J].中国医药,2018,13(7):1052-1055.
[15]Ohtake S,Miyawaki S,Fujita H,et al.Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia:the JALSGAML201 Study[J].Blood,2011,117(8):2358-2365.
[16]Horton T M,Perentesis J P,Gamis A S,et al.A Phase2 study of bortezomib combined with either idarubicin/cytarabine or cytarabine/etoposide in children with relapsed,refractory or secondary acute myeloid leukemia:a report from the Children's Oncology Group[J].Pediatr Blood Cancer,2015,61(10):1754-1760.
[17]朱齐兵,陈慧君,唐小万,等.急性白血病患者化疗后血流感染病原菌分布及危险因素分析[J].中国医药,2018,13(1):104-107.
[18]Sekine L,Morais V D,Lima K M,et al.Conventional and high-dose daunorubicin and idarubicin in acute myeloid leukaemia remission induction treatment:a mixed treatment comparison meta-analysis of 7258 patients[J].Hematol Oncol,2016,33(4):212-219.
[19]Kantarjian H,O'Brien S,Jabbour E,et al.Effectiveness of homoharringtonine(omacetaxine mepesuccinate)for treatment of acute myeloid leukemia:a meta-analysis of Chinese studies[J].Clin Lymphoma Myeloma Leuk,2015,15(1):13-21.
[20]李婷婷,孙雪冬,董征,等.FLT3-ITD阳性与阴性急性髓细胞白血病的实验室特征及预后比较[J].解放军医学杂志,2013,38(6):501-505.
[21]胡琴,刘维,邵宏.药物性肝损伤的药物治疗研究进展[J].中国临床药理学与治疗学,2016,21(2):231-236.
[22]毕磊,曹丹阳,郭智.恶性血液病患者蒽环类药物化疗期间心电图异常分析[J].中国循证心血管医学杂志,2017,9(11):1354-1356.
[23]何吉琼.急性髓系白血病应用去甲氧柔红霉素及柔红霉素的诱导治疗研究[J].临床医学研究与实践,2016,1(16):30,32.
[24]胡文广.急性髓系白血病应用去甲氧柔红霉素及柔红霉素的诱导治疗研究[J].中国医药科学,2015,5(3):117-118,121.