摘要
目的研究合并使用粒细胞集落刺激因子(G-CSF)的低强度的化疗方案对高危骨髓增生异常综合征(MDS)或MDS转化的急性髓细胞白血病(AML)的治疗效果。方法11例从未接受过诱导化疗的高危MDS或MDS转化的AML患者入选本试验组。治疗方法:高三尖杉酯碱和阿糖胞苷分别每天1mg和25mg静脉滴注,连续14d;G-CSF以每天1次300μg皮下注射,于化疗前12h开始,持续使用至化疗结束或外周血白细胞计数>20×109/L。使用本方案1个疗程若取得完全缓解(CR)则给予常规化疗方案巩固或维持,若患者对本方案无反应则改用其他治疗方法。结果1个疗程后6例(54.5%)患者达到CR,1例(9.1%)患者达到部分缓解(PR)。6例CR患者中5例分别在2、3、6、8、16个月后复发,3例复发患者再行相同化疗方案治疗只能达到PR。11例患者中9例已死亡,平均生存期(从诱导化疗开始)为9.2个月。11例患者在白细胞减少阶段发生的感染性并发症比传统的化疗轻,且无治疗相关死亡发生。结论使用G-CSF低强度的化疗方案对高危MDS或MDS转化的AML有一定疗效,但缓解期较短。
Objective To study the affection of the moderate intensity protocol with granulocyte colony - stimulating factor （ G - CSF） priming treating on the patients with high - risk myelodysplastic syndromes （MDS） or post - MDS acute myeloid leukemia （AML）. Methods Eleven adult patients with high -risk MDS or post - MDS AML who never received induction chemotherapy were enrolled in this trial to evaluate the efficacy of sequential low - dose homoharringtonine/cytarabine （ Ara - C） chemo- therapy with G - CSF priming. Homoharringtonine and Ara - C were infused intravenously at doses of 1 mg and 25 mg daily respectively, for 14 consecutive days. G - CSF was injected subcutaneously once dai- ly at a dose of 300μg, 12 hours prior to chemotherapy and continued until the end of chemotherapy or when the peripheral leukocyte counting reached 〉 20×10^9/L. This regimen was given for one course for induction, and was followed by conventional chemotherapy as maintenance or consolidation when complete remission（CR） achieved, or succeeding with other treatment when no response could be observed. Resuits Six patients achieved CR （54.5%） and one achieved partial remission （PR） （9.1%） with one course of treatment. Among 6 of 11 patients with CR, 5 relapsed at 2,3,6,8 and 16 months respectively. Three relapsed patients were retreated with the same protocol but achieved only one partial responses. Nine of the 11 patients had been died and their mean survival （ since induction chemotherapy） was 9.2 months. Infectious complications during cytopenia were less serious than conventional chemotherapy with no treatment - related. Conclusion This moderate intensity protocol with C - CSF priming is effective and safe but remissions are of short duration.
出处
《中国医师进修杂志（内科版）》
2006年第9期33-35,56,共4页
Chinese Journal of Postgraduates of Medicine
