Intensive induction chemotherapy with regimen containing intermediate dose cytarabine in the treatment of de novo acute myeloid leukemia
Intensive induction chemotherapy with regimen containing intermediate dose cytarabine in the treatment of de novo acute myeloid leukemia
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中剂量阿糖胞苷方案强化诱导化疗治疗新发急性髓系白血病
DOI：
10.1002/ajh.21441
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发表时间：
2009-07-01
影响因子：
12.8
通讯作者：
Wang, Jianxiang
中科院分区：
文献类型：
--
作者：
Liu, Jiazhuo;Mi, Yingchang;Wang, Jianxiang
目的：探讨中剂量阿糖胞苷联合诱导治疗新发急性髓性白血病（AML）患者的远期预后，并探讨细胞遗传学异常对预后的影响。87例AML患者采用含有中剂量阿糖胞苷（IDAra-C）作为诱导治疗的HAD方案治疗，83例核型结果根据SWOG标准分为3个细胞遗传学组。评估各组患者的完全缓解率（CR）、无病生存期（DFS）和总生存期（OS）。87例患者的CR率为80/87（92%）。中位DFS和CIS未达到（NR）。1年和3年的DFS分别为76.3%和63.4%。1年和3年的总生存率分别为86.0%和58.7%。根据SWOG标准，CR率、中位DFS和OS为100%，有利组为NR和NR；88.9%为NR，中间组为16个月；83.3%，不良组为4.5个月，7.5个月。除不良组与中间组CR率差异外，三组间差异均有统计学意义。含有IDAra-C作为诱导化疗方案的HAD方案对成人新生AML患者有效，并且比标准剂量的阿糖胞苷（SDAra-C）方案具有更高的CR率和更长的生存期。大多数病人都能忍受这种治疗。尽管在诱导化疗中加入了IDAra-C，但细胞遗传学仍然是一个重要的预后因素。三组间差异有统计学意义。点。中华血液学杂志，2009,34(4):422-427。(C) 2009 Wiley-Liss, Inc。
To improve long-term outcome of de novo acute myeloid leukemia (AML) patients by intermediate dose of cytarabine integrated in induction therapy and to explore the impact of cytogenetic abnormalities on the prognosis. Eighty-seven AML patients were treated with HAD regimen containing intermediate dose cytarabine (IDAra-C) as induction therapy, 83 from which with karyotype results were divided into three cytogenetic groups according to SWOG criteria. Complete remission (CR) rate, disease-free survival (DFS), and overall survival (OS) among different groups were evaluated. The CR rate of the 87 cases was 80/87 (92%). Median DFS and CIS have not reached (NR). DFS rates at 1 and 3 years were 76.3% and 63.4%, respectively. OS rates at 1 and 3 years were 86.0% and 58.7%, respectively. According to SWOG criteria, CR rate, median DFS, and OS were 100%, NR and NR for the favorable group; 88.9%, NR, and 16 months for the intermediate group; 83.3%, 4.5 months, and 7.5 months for the adverse group. The differences among the three groups were statistically significant excepting for CR rate between adverse and intermediate groups. HAD regimen containing IDAra-C as induction chemotherapy regimen is effective in de novo AML of adult patients and can achieve higher CR rate and longer survival than standard dose of cytarabine (SDAra-C) regimen. Most of the patients were able to endure the therapy. Cytogenetics is still an important prognostic factor despite of the incorporation of IDAra-C in induction chemotherapy. The differences among the three groups were statistically significant. Am. J. Hematol. 84:422-427, 2009. (C) 2009 Wiley-Liss, Inc.