| 引用本文： |
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陆惠娜,秦伟,高青梅,等.FA方案巩固强化治疗急性髓系白血病的临床观察[J].同济大学学报（医学版）,2011,32(1):56-60. [点击复制]
- LU Hui-na,QIN Wei,GAO Qing-mei,et al.Primary clinical study of FA regimen as consolidation therapy for patients with acute myeloid leukemia[J].同济大学学报（医学版）,2011,32(1):56-60. [点击复制]
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| 摘要: |
| 目的 探讨氟达拉滨联合中剂量阿糖胞苷即FA方案巩固强化治疗急性髓系白血病（acute myeloidleukemia,AML）的临床疗效及副作用。方法 观察组28例AML患者采用FA方案进行巩固强化治疗,氟达拉滨30 mg/m2（1~3 d）,静脉滴注,阿糖胞苷2 g/m2,（1~3 d）,静脉滴注,阿糖胞苷在氟达拉滨结束后4 h应用。同期对照组10例AML患者采用大剂量阿糖胞苷进行巩固强化治疗,即Ara-C 3 g/m2,q12 h×3 d。结果 FA组28例AML患者CR时间为109~1 735 d,14例患者持续完全缓解（continuous complete remission,CCR）2年以上,（3年）生存率为21.4%,1 300 d（＞3年）的生存率为14.3%,与大剂量阿糖胞苷组没有统计学差异。7例患者于CCR后3~47个月复发,复发患者均存在各种不良预后因素,至少处于中高危分级。不良反应主要为骨髓抑制和继发感染,但总体而言骨髓抑制时间较短,非血液毒性较轻,住院时间在3周左右。结论 氟达拉滨能提升胞内Ara-CTP浓度,增强抗白血病作用。FA方案多疗程巩固治疗低中危AML,能减少AML复发,提高总体生存率和无病生存率,临床疗效肯定,不良反应较少,值得进一步深入研究。 |
| 关键词: 急性髓系白血病 FA方案 巩固强化 |
| DOI：10.3969/j.issn1008-0392.2011.01.056 |
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| 基金项目:国家973项目子课题(2010CB529400); 国家自然科学基金资助项目(81070430) |
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| Primary clinical study of FA regimen as consolidation therapy for patients with acute myeloid leukemia |
| LU Hui-na,QIN Wei,GAO Qing-mei,ZHANG Wen-jun,XIONG Hong,LIANG Ai-bin |
| (Dept.of Hematology,Tongji Hospital,Tongji University,Shanghai 200065,China) |
| Abstract: |
| Objective To explore the efficacy and adverse effects of the combination of Fludarabine and Cytarabine(FA) as the consolidation therapy for patients with acute myeloid leukemia(AML).Methods Twenty-eight patients with AML under complete remission were consolidated with FA regimen which includes Fludarabine 30mg/m2(1~3d) and Cytarabine(Ara-C) 2g/m2(1~3d).Ara-C was administered as a continuous sequential infusion 4 hours later when the application of Fludarabine had been over.Another 10 AML patients with matched conditions treated with high dose Ara-C(Ara-C 3g/m2,every 12 hrs for 3 d) were designated as controls.Results The time of complete remission in 28 patients in FA group was 109-1,735 days.Fourteen patients(50%) in FA group achieved continuous complete remission for more than 2 years.The survival rates of 3 years and 1,300 days were 21.4% and 14.3% respectively.There was no statistically difference between FA group and HDAra-C group in CCR.Seven patients relapsed after 3-47 months of treatment.The main toxicity was myelosuppression.The time of myelosuppression was short and non-hematotoxicity was gentle.The average hospitalization for FA group was about 3 weeks.Conclusion Fludarabine can increase the concentration of Ara-CTP in cells and enhance its effects of anti-leukemia.The FA regimen is effective and safe as consolidation therapy in AML with acceptable toxicity and is not associated with an increased incidence of infections compared to conventional HDAra-C regimen. |
| Key words: acute myeloid leukemia FA regimen consolidation |
