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目的:探讨减低剂量去甲氧柔红霉素联合阿糖胞苷(IA)方案治疗老年急性髓细胞白血病(AML)患者的疗效和不良反应。方法:42例老年AML患者分别以减低剂量IA方案、标准剂量IA方案和标准剂量米托蒽醌联合阿糖胞苷方案(MA)治疗,比较3组病例在临床疗效、不良反应、病死率等指标上的差异。结果:减低剂量IA组完全缓解(CR)6例(40%),标准剂量IA组CR5例(38%),标准剂量MA组CR5例(35%),减低剂量IA组与标准剂量IA/MA组相比CR率差异无统计学意义(P>0.05)。减低剂量IA组4级血小板减少和白细胞降低率低于标准剂量IA/MA组(P<0.05),非造血系统不良反应可耐受,治疗相关死亡率低于标准剂量IA/MA组(P<0.05)。患者主要死于骨髓抑制阶段感染诱发的脏器功能衰竭。结论:减低剂量IA方案是老年AML的治疗有效且耐受良好的治疗方案。
Objective: To investigate the curative effect and adverse reactions in patients with senile acute myeloid leukemia (AML) treated with the dose of demethoxyribacillin combined with cytarabine (IA). Methods: Forty-two elderly patients with AML were treated with reduced dose IA, standard dose IA and standard dose mitoxantrone combined with cytarabine (MA). The clinical efficacy, adverse reactions, mortality and other Differences in indicators. Results: Six patients (40%) with complete remission (CR) were treated in IA group, CR5 in standard dose IA group (38%), CR5 in standard dose MA group (35% There was no significant difference in CR rate between the two groups (P> 0.05). The level of grade 4 thrombocytopenia and leukopenia in IA group were lower than those in IA / MA group (P <0.05), and the non-hematologic adverse reactions were tolerable and treatment-related mortality was lower than IA / MA group (P < 0.05). Patients died mainly from organ failure due to infection during the stage of myelosuppression. Conclusions: The reduced dose IA regimen is a therapeutically effective and well-tolerated treatment for elderly AML.