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目的 探讨急性髓系白血病 (AML)诱导缓解后的适宜治疗周期。方法 治疗并随访观察我院 7年收治的原发、初治AML 191例 ,采用SPSS软件分析所得数据。结果 191例原发初治AML采用HA、DA、AA、HAD方案分组诱导化疗 ,完全缓解 (CR)率 81.4% ,其 1～ 2个疗程CR率 89.9%。 144例可分析生存期的CR患者中位无病生存 (DFS) 9.6个月 ,3年实际DFS率为 2 1.6 % ,5年DFS率预计为 12 .9% ,CR后巩固强化治疗 <6个疗程者中位DFS为 7.1个月 ,3年DFS率为 11.4% ,5年DFS率为 6 3% ;治疗≥ 6个疗程者中位DFS为 35 .3个月 ,3年DFS率为 43.2 % ,5年DFS率为2 7.0 % ,二者差异具有显著性。其中治疗≥ 8个疗程者中位DFS为 48.8个月 ,3年DFS率为 5 7.9% ,5年DFS率为 31 6 % ,略高于治疗≥ 6个疗程的全部病例 ,但差异无统计学意义。结论 AMLCR后标准剂量化疗巩固强化至少应 6个疗程 ,以 8个疗程以上为宜。建议AML的治疗至少维持 1年左右
Objective To investigate the appropriate treatment period after induction of remission in acute myeloid leukemia (AML). Methods A total of 191 patients with primary or newly treated AML admitted to our hospital were treated and followed up for 7 years. SPSS software was used to analyze the data. RESULTS: In 191 initially untreated AML patients, HA, DA, AA, and HAD regimens were used to induce chemotherapy. The complete response (CR) rate was 81.4%, and the CR rate of 1 to 2 courses was 89.9%. The median disease-free survival (DFS) was 9.6 months in 144 patients with an analysis of survival, the actual DFS was 21.6% in 3 years, the DFS rate in 5 years was 12.9%, and the consolidation after intensive treatment was 6 The median DFS was 7.1 months. The 3-year DFS rate was 11.4%. The 5-year DFS rate was 63%. The median DFS was 35.3 months and the 3-year DFS rate was 43.2%. The 5-year DFS rate was 27.0%, and the difference was significant. The median DFS for treatment ≥ 8 courses was 48.8 months, the DFS rate for 3 years was 5 7.9%, and the DFS rate for 5 years was 316%, which was slightly higher than that of all cases treated ≥ 6 courses, but the difference was not statistically significant. significance. Conclusion After consolidation of the standard dose of AMLCR chemotherapy consolidation should be at least 6 courses, more than 8 courses is appropriate. It is recommended that AML treatment be maintained for at least 1 year