【摘要】 目的:比较柔红霉素(rubomycin)联合阿糖胞苷(cytarabine,Ara-C)(DA方案)、米托蒽醌(mitoxantrone)联合阿糖胞苷(MA方案)治疗急性非淋巴细胞白血病(急非淋)的疗效和不良反应。方法:用随机对照的方法将初治117例急非淋分为DA方案组(DA组,59例)和MA方案组(MA组,58例)治疗。观察两组的疗效及不良反应。结果:MA组与DA组完全缓解率分别为83%、61%,第1次治疗的完全缓解率分别为79%、47%,总有效率分别为90%、68%,差异均有统计学意义(P<0.05)。DA组与MA组在急性粒细胞白血病未分化型(M1)、急性粒细胞性白血病部分分化型(M2)、急性早幼粒细胞白血病(M3)类型的急非淋中完全缓解率差异无统计学意义。在急性粒-单核细胞白血病(M4)、急性单核细胞白血病(M5)中,MA组与DA组的完全缓解率分别为79%、34%,差异有统计学意义(P<0.05)。两组不良反应中,在白细胞下降至最低值、白细胞上升至1.0×109/L、血红蛋白上升至100g/L、血小板上升至100×109/L、粒细胞缺乏持续时间上,MA组较DA组明显延长,出现上呼吸道感染、肛周感染、败血症的机会较多。结论:建议DA方案目前仍是M1、M2、M3的首选方案,而M4、M5应首选MA方案。更多还原

【Abstract】 Objective: To compare the efficacy and adverse effects of rubomycin plus aracytidine (DA) with mitoxantrone plus aracytidine (MA) in the treatment of acute nonlymphocytic leukemia (ANLL). Methods: 117 cases of previously untreated ANLL patients were randomly divided into two groups: DA and MA treated group. The efficacy and adverse effects of both groups were compared. Results: The complete remission (CR) rate was 83% and 61% in DA and MA treated group, respectively. The CR rate after the first course of chemotherapy was 79% and 47% , and the total response rate was 90% and 68% , respectively. Both were significantly higher than those of DA group (P<0.05). There was no significant difference in CR rate of the types of M1, M2, M3 between the two groups (P>0.05). CR rate in the types of M4 and M5 treated with MA was 79% , significantly higher than that of DA group (34% , P<0.05). MA group had significantly longer duration when white blood cell decreased to the lowest level, white blood cell increased to 1.0× 109/L, hemoglobin increased to 100 g/L, thrombocyte increased to 100× 109/L and longer agranulocytosis. The incidence of respiratory infection, peri anal infection and septicemia in MA group was significantly higher than that of DA group. Conclusion: DA regimen is recommended as the regimen of choice for M1, M2 and M3 while MA should be the regimen of choice for in M4 and M5.更多还原