[Efficacy and safety of the HAA regimen as induction chemotherapy in 236 de novo acute myeloid leukemia].
[Efficacy and safety of the HAA regimen as induction chemotherapy in 236 de novo acute myeloid leukemia].
复制标题
DOI：
10.3760/cma.j.issn.0253-2727.2013.10.001
复制
发表时间：
2013-10-01
影响因子：
--
通讯作者：
Jin, Jie
中科院分区：
文献类型：
--
作者：
Ye, Pei-pei;Mu, Qi-tian;Jin, Jie
目的：评价HAA方案(高三尖杉酯碱、阿糖胞苷、阿克拉霉素)诱导治疗初治急性髓系白血病(AML)的疗效和安全性。方法：对236例初治AML患者采用HAA方案诱导化疗的疗效和安全性进行回顾性分析。检测完全缓解率(CR)。用Kaplan-Meier法估计总生存期(OS)和无复发生存期(RFS)，用Log-ranch检验比较两组的差异。结果：总的CR率为78.0%，65.7%的患者在第一个诱导周期内达到CR。早期死亡率为4.7%。中位随访时间41个月(1-161个月)。估计5年OS率为44.9%，5年RFS率为45.5%。细胞遗传学好、中、差的患者完全缓解率分别为92.9%、78.6%和41.7%。中良组5年生存率分别为61.1%和45.1%。好组和中组的5年生存率分别为49.0%和45.4%。不良组中位生存期仅为5个月。HAA方案的副作用可耐受，其中最常见的毒副反应是骨髓抑制和感染。结论：HAA方案具有较高的CR率和较长的生存期，毒性可耐受。
OBJECTIVE: To evaluate the efficacy and safety of the HAA regimen (homoharringtonine, cytarabine and aclarubicin) as induction chemotherapy in de novo acute myeloid leukemia (AML).METHODS: The efficacy and safety of 236 de novo AML patients who received the HAA regimen as induction chemotherapy were retrospectively analyzed. The complete remission (CR) rate was assayed. Kaplan-Meier method was used to estimate overall survival (OS) and relapse free survival (RFS), and the differences were compared by Log-rank test.RESULTS: The overall CR rate was 78.0%, and 65.7% of the patients attained CR in the first induction cycle. The early death rate was 4.7%. The median followup time was 41(1-161) months. The estimated 5-year OS and 5-year RFS rates were 44.9% and 45.5%, respectively. The CR rates of patients with favorable, intermediate and unfavorable cytogenetics were 92.9%,78.6%and 41.7%, respectively. The 5-year OS of favorable and intermediate group were 61.1% and 45.1%, respectively. The 5- year RFS of favorable and intermediate group were 49.0% and 45.4%, respectively. The median survival time of unfavorable group was only 5 months. The side effects associated with the HAA regimen were tolerable, in which the most common toxicities were myelosuppression and infection.CONCLUSION: The HAA regimen is associated with a higher rate of CR and longer survival time and its toxicity could be tolerated.