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目的:观察小剂量HA方案治疗初诊成人高白细胞性急性髓系白血病(HAML)1个疗程后的疗效及不良反应。方法:23例初诊成人HAML患者,予以小剂量阿糖胞苷10mg/(m2·d),皮下注射,1次/12h,及高三尖杉酯碱2mg/d,静脉滴注,共14d。化疗过程中,白细胞计数<10×109/L时予以粒细胞集落刺激因子300μg/d,皮下注射,直至中性粒细胞绝对值≥1.5×109/L时停用。结果:15例(65.2%)获得完全缓解,2例(8.7%)获得部分缓解,总有效率73.9%。6例无效,其中2例死亡,早期病死率8.7%。白细胞计数降至10×109/L以下所需时间为6(4~10)d。化疗期间主要不良反应为骨髓抑制,表现为粒细胞缺乏及继发感染、出血。结论:小剂量HA方案治疗初诊成人HAML有效率高,不良反应可控制。
Objective: To observe the efficacy and side effects of low-dose HA regimen in the treatment of newly diagnosed adult high leucocyte acute myeloid leukemia (HAML) after a course of treatment. Methods: Twenty - three newly diagnosed adult HAML patients were given intravenous drip for 14 days with low dose of cytarabine 10mg / (m2 · d), subcutaneous injection, once / 12h and homoharringtonine 2mg / d. Chemotherapy, leukocyte count <10 × 109 / L when granulocyte colony stimulating factor 300μg / d, subcutaneous injection, until the neutrophil absolute value ≥ 1.5 × 109 / L when disabled. Results: Complete remission was achieved in 15 cases (65.2%) and partial remission in 2 cases (8.7%), with a total effective rate of 73.9%. 6 were ineffective, 2 of them died, the early mortality rate was 8.7%. Leukocyte count down to 10 × 109 / L the time required for the 6 (4 ~ 10) d. The main adverse reactions during chemotherapy were myelosuppression, manifested as agranulocytosis and secondary infection, bleeding. Conclusion: The low-dose HA regimen is effective in treating newly diagnosed adult HAML and the adverse reaction can be controlled.