小剂量高三尖杉酯碱、阿糖胞苷和G-CSF预激诱导治疗高危MDS或MDS转化的AML.doc

小剂量高三尖杉酯碱、阿糖胞苷和G-CSF预激诱导治疗高危MDS或MDS转化的AML
小剂量高三尖杉酯碱,阿糖胞苷和
G—CSF预激诱导治疗高危MDS
或MDS转化的AML
苏基滢李晓常春康吴凌云宋陆茜杨梅如浦权
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33?
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临床论着?
【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
: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300p,g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×
取得完全缓解(Ca)那么给予常规化疗方案稳固或维持,假设患者对本方案无反响那么改用其他治疗方
(%)患者到达CR,1例(%)患者到达局部缓解(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到达PR.
11例患者中9例已死亡,平均生存期(从诱导化疗开始):11例患者在白细胞减少阶
—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.
【关键词】粒细胞集落刺激因子;骨髓增生异常综合征;急性髓细胞白血病;高三尖杉
醅碱;阿糖胞苷
Inductionchemotherapy训tlIlow—dosehomoharringtonine,cytarabine,andgranulocytecolony
——
sthnulatingfactorpriminginpatientswithadvancedmyelodysplasticsyndromeorpost——myelo-
dysplasticsyndromeacutemyeloidleukemiaSUJi—ying,12Xiao,CHANGChun—hang,
,lg—yun,SONGLu—xi,YANGMei—ru,PUQu口,,TheSixthHospitalAf-
fdiatedofShanghaiJiaotongUniversity,Shanghai200233,China
【Abstract】0bjectiveTostudytheaffectionofthemoderateintensityprotocolwithgranulocyte
colony—stimulatingfactor(G—CSF)primingtreatingonthepatientswithhigh—riskmyelodysplastic
syndromes(MDS)orpost—MDSacutemyeloidleukemia(AML).MethodsElevenadultpatients
withhigh——riskMDSorpost——MDSAMLwhoneverreceivedinductionchemotherapywereenrolledin
thistrialtoevaluatetheefficacyofsequentiallow—dosehomoharringtonine/eytarabine(Ara—C)ehemo-
therapywithG——Cwereinfusedintravenouslyatdosesof1
—CSFwasinjectedsubcutaneouslyoncedai?
lyatadoseof300g,12hourspriortochemotherapyandcontinueduntiltheendofchemotherapyor
whentheperipheralleukocytecountingreached>20×10/L.,I1lisregimenwasgivenforonecoursefor
induction,andWasfoUowedbyconventionalchemotherapyasmaintenanceorconsofidationwhencomplete
suitsSixpatientsachievedCR(%)andoneachievedpartialremission(PR)(%)withone
,5relapsedat2,3,6,8and16monthsrespectively.
Threerelapsedpatientswereretreatedwiththesalneprotocolbutac