【摘要】 目的:研究Mito-FLAG方案(米托蒽醌、氟达拉滨、阿糖胞苷和粒细胞集落刺激因子联合应用)治疗难治/复发急性髓细胞白血病的疗效和不良反应。方法:Mito10mg/dd1(1例15mg/d,d1;另有1例5mg/d,d1-5);Flu30mg·m-2·d-1静脉滴注30min,d1-5;Ara-C1.5g·m-2·d-1静脉滴注4h,d1-5;G-CSF300μg·kg-1·d-1从d0开始一直应用到白细胞恢复至20.0×109/L。治疗9例(11例次)难治/复发AML。结果:9例患者完全缓解率44.4%,其中7例难治AML的完全缓解率为57%,所有病例总有效率达66.7%,无效3例,其中早期死亡1例。毒副作用为骨髓抑制、消化道症状、轻度黄疸和静脉炎等。结论:Mito-FLAG方案治疗难治复发AML有较好的疗效,且毒副作用可以耐受,可用于治疗对其他化疗方案无效的难治/复发AML,并为患者赢得了进行造血干细胞移植的时机。更多还原

【Abstract】 Objective:To observe the therapeutic effects and side effects of Mito-FLAG regimen (mitoxantrone, fludarabine, Ara-C, and granulocyte-colony stimulating factor (G-CSF) for refractory or relapsed acute myeloid leukemia (AML).Methods: The regimen consisted of Mito 10 mg/d on d1 (one patient received 15 mg/d on d1, and another one received 5 mg/d, from d1 to d5); Flu 30 mg·m-2·d-1 i.v. 30 min, from d1 to d 5; Ara-C 1.5 g·m-2·d-1 i.v. 4 h, from d1 to d5, and G-CSF 30 μg·kg-1·d-1 from d0 until the WBC >20×109/L. Nine cases (total 11 times) of refractory or relapsed acute myeloid leukemia were treated with this regimen. Results:In the 9 cases of leukemia the complete remission rate was 44.4% (4/9), and for the 7 cases of refractory AML, complete remission rate was 57%. The overall responsible rate was 66.7% (6/9). Three cases had no response and among them one case died at early period.The main toxicities were myelosupression, gastrointestinal side effects, slight jaundice, and phlebitis. Conclusion:Mito-FLAG shows favorable outcome for refractory and relapsed acute leukemia, and can be employed for the patients with refractory or relapsed AML who had no response to the first line regimen or other salvage regimens. It will get a chance for further hematopoietic stem cell transplantation.更多还原