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目的:探讨去甲基化药物地西他滨联合减量氟达拉滨+阿糖胞苷+粒细胞刺激因子(FLAG)方案在治疗复发难治急性髓系白血病(AML)中的疗效及安全性。方法:选择复发难治AML 10例,予地西他滨联合减量FLAG方案(地西他滨15 mg/m2,qd,d1~d5;氟达拉滨25 mg/m2,qd,d1~d5;阿糖胞苷1 g/m2,qd,d1~d5,氟达拉滨后3 h用,维持3 h;G-CSF 300μg qd,自d0起)进行再诱导化疗,观察完全缓解率、不良反应等安全性指标,并与既往常用复发难治AML再诱导方案进行比较。结果:10例患者中,经1个疗程化疗,7例(70%)获得完全缓解(CR),1例(10%)获得部分缓解(PR),2例(20%)未缓解死亡。中性粒细胞平均恢复时间为化疗后(16.28±2.36)d,血小板平均恢复时间为化疗后(14.14±2.19)d。中位随访时间255 d(28~325 d),总体生存率50%。与常规化疗相比,无特殊的非血液学不良反应。结论:地西他滨联合减量FLAG方案对复发难治型急性髓系白血病疗效确切,缓解率高。
Objective: To investigate the efficacy and safety of demethylation drug decitabine combined with fludarabine + cytarabine + granulocyte-stimulating factor (FLAG) regimen in the treatment of relapsed and refractory acute myeloid leukemia (AML) Sex. Methods: Ten patients with relapsed or refractory AML were selected. Decitabine plus degenerative FLAG regimen (decitabine 15 mg / m2, qd, d1 ~ d5, fludarabine 25 mg / m2, qd, d1 ~ d5 ; Cytarabine 1 g / m2, qd, d1 ~ d5, fludarabine after 3 h with and maintain 3 h; G-CSF 300 g qd, since d0) reinduction chemotherapy to observe the complete remission rate, poor Response and other safety indicators, and with the previous recurrence and refractory AML re-induction programs were compared. Results: In 10 patients, complete remission (CR) was achieved in 7 patients (70%), partial response (PR) in 1 patient (10%) and death was not relieved in 2 patients (20%) after one course of chemotherapy. The average recovery time of neutrophils was (16.28 ± 2.36) days after chemotherapy, and the average recovery time of platelets was (14.14 ± 2.19) days after chemotherapy. The median follow-up time was 255 days (28-325 days) with an overall survival rate of 50%. Compared with conventional chemotherapy, no special non-hematologic adverse reactions. CONCLUSION: Decitabine combined with reduced-dose FLAG regimen is effective in treating recurrent refractory acute myeloid leukemia with high remission rate.