标题：地西他滨联合减量MA/DA方案治疗复发难治性急性髓系白血病临床观察

      作者：梁艳，唐元艳，熊涛，邓鸣凤，张利铭，黄知平
    (荆州市中心医院血液内科，湖北 荆州 434020)

      卷次： 2016年27卷13期

      【摘要】 目的 观察地西他滨联合减量MA/DA方案治疗复发难治性急性髓系白血病患者的疗效及安全性。
方法 选取2012年8月至2015年6月本院收治的18例复发难治性急性髓系白血病患者，予以地西他滨联合减量
MA [地西他滨 20 mg/(m2· d)，d1~5；米托蒽醌 8~12 mg/m2，d6~8；阿糖胞苷 100 mg/m2，d6~8]/DA方案[地西他滨
20 mg/(m2· d)，d1~5；柔红霉素 40~45 mg/m2，d6~8；阿糖胞苷 100 mg/m2，d6~8]，观察患者临床疗效及不良反应。
结果 18例患者中完全缓解(CR) 6例(33.3%),部分缓解(PR) 5例(27.8%)，总有效率(ORR)为61.1%；8例染色体异常
患者治疗后1例获完全细胞遗传学缓解，3例部分细胞遗传学缓解，总有效率为50.0%。不良反应主要为骨髓抑制
及继发感染，经过输血和抗感染等支持治疗均可以耐受。随访至2015年6月，患者中位生存为8个月。结论 地西
他滨联合减量MA/DA方案治疗复发难治性急性髓系白血病在血液学及细胞遗传学上可以获得较好疗效，且毒副
作用较轻，耐受性良好。

      【关键词】 复发难治急性髓系白血病；地西他滨；临床疗效

      【中图分类号】 R733.71 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2101—03


Clinical observation of decitabine combined with low-dose MA/DA regimen in the treatment of patients with
refractory or relapsed acute myeloid leukemia.
LIANG Yan, TANG Yuan-yan, XIONG Tao, DENG Ming-feng, ZHANG
Li-ming, HUANG Zhi-ping. Department of Hematology, Jingzhou Central Hospital, Jingzhou 434020, Hubei, CHINA

【Abstract】 Objective To investigate the clinical efficacy and safety of decitabine combined with the reduced
quantity of cytarabine (Ara-C) and mitoxantrone (MIT) regimen in the treatment of patients with refractory or re-
lapsed acute myeloid leukemia. Methods Eighteen cases with refractory or relapsed acute myeloid leukemia in
our hospital from August 2012 to June 2015 were treated with decitabine combined with reduced quantity of MA
regimen (decitabine 20 mg/(m2· d), d1~5; MIT 8~12 mg/m2, d6~8; Ara-c100 mg/m2, d6~8)/DA regimen (decitabine
20 mg/(m2· d), d1~5; DNR 40~45 mg/m2, d6~8; Ara-c100 mg/m2, d6~8), and the clinical outcome and adverse events
were recorded. Results Among 18 patients, 6 (33.3%) patients achieved complete remission (CR), and 5 (27.8%) were
partial remission (PR), with overall remission rate (ORR) of 61.1%; After treatment, of 8 patients with chromosomal ab-
normalities, 1 patient achieved complete cytogenetic remission, 3 patients were partial cytogenetic remission, and the over-
all response rate was 50.0%. Adverse events mainly include myelosuppression and secondary infection, which could be
well tolerated with the help of blood transfusions and anti-infection supportive treatment. Following up to June 2015, the
median overall survival (OS) was 8 months. Conclusion Decitabine combined with the reduced quantity of MA/DA regi-
men is effective and well tolerated in the treatment of patients with refractory or relapsed acute myeloid leukemia.

      【Key words】 Refractory or relapsed acute myeloid leukemia; Decitabine; Clinical efficacy
·论 著·
6350.2016.13.013