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目的:评价氟达拉滨联合阿糖胞苷(FA)方案对急性髓系白血病(AML)不同治疗阶段的临床疗效。方法:根据应用FA方案治疗阶段将75例AML患者分为4组:①第1个疗程诱导化疗未缓解组21例;②2次及2次以上诱导治疗未缓解组21例;③早期复发组14例;④晚期复发组19例;其中后3组为难治复发性AML,比较不同组间疗效。结果:4组患者的完全缓解(CR)率分别为81.0%(17/21)、42.9%(9/21)、28.6%(4/14)及31.6%(6/19)。第1疗程诱导化疗未缓解组CR率明显高于复发难治性AML的CR率35.2%(19/54)(P=0.002)。Logistic回归分析结果显示既往化疗次数与CR率有显著相关性(P=0.027)。主要不良反应为骨髓抑制和继发感染。结论:对于第1个疗程化疗未缓解的AML患者,FA方案可作为一种有效的选择。
Objective: To evaluate the clinical efficacy of fludarabine combined with cytarabine (FA) in different treatment stages of acute myeloid leukemia (AML). Methods: According to the application of FA regimen, 75 patients with AML were divided into 4 groups: ① in the first course, 21 patients were induced by chemotherapy-induced remission; ② in 21 patients who were treated by 2 or more induction-induced remissions; ③ in the early relapse group 14 Cases; ④ late recurrence group of 19 patients; of which the latter three groups of refractory relapsed AML, compare the efficacy of different groups. Results: The complete remission (CR) rates of the four groups were 81.0% (17/21), 42.9% (9/21), 28.6% (4/14) and 31.6% (6/19), respectively. The CR rate in the first course of chemotherapy-induced chemotherapy was significantly higher than that in the recurrent refractory AML (35.2%, 19/54) (P = 0.002). Logistic regression analysis showed that the number of previous chemotherapy and CR rate was significantly correlated (P = 0.027). The main adverse reactions were myelosuppression and secondary infection. Conclusions: The FA regimen is an effective option for patients with AML who are not remitted by the first course of chemotherapy.