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本研究探讨以大剂量阿糖胞苷(Ara-C)联合氟达拉滨(Flud)和粒细胞集落刺激因子(G-CSF)即FLAG方案巩固治疗急性髓系白血病(AML)对自体造血干细胞动员的影响。对15例AML患者在诱导缓解后采用FLAG方案巩固治疗(氟达拉滨,50mg/d,第1-5天;Ara-C2g/(m2.d),第1-5天;G-CSF300μg/d,皮下注射,化疗前1天至中性粒细胞>1.0×109/L)。15例中男10例,女5例,中位年龄36(14-51)岁,13例为初发AML,2例为复发难治AML。12例FLAG巩固2个疗程,3例巩固3个疗程。动员方案为:9例为FLAG,6例大剂量足叶乙甙(VP16)+G-CSF。结果表明:15例患者中11例(73.3%)被证实有足够的造血干细胞(CD34+细胞(2.0×106/kg),CD34细胞中位数为3.52×106/kg[(2.2-4.6)×106/kg]。在4例仅采集到足够的单个核细胞(MNC),而CD34+细胞含量却较低。结论:2个疗程的FLAG巩固治疗对AML患者的造血干细胞影响不明显,毒副作用不明显且不影响自体外周血造血干细胞的动员。
This study was to investigate the effects of Ara-C plus fludarabine (Flud) and granulocyte colony-stimulating factor (G-CSF), ie, FLAG regimen on the treatment of acute myeloid leukemia (AML) on autologous hematopoietic stem cells The impact of mobilization. Fifteen patients with AML were treated with FLAG regimen (fludarabine, 50 mg / d, day 1-5; Ara-C2g / (m2.d) d, subcutaneous injection, 1 day before chemotherapy to neutrophils> 1.0 × 109 / L). Fifteen males included 10 males and 5 females, with a median age of 36 (14-51) years, 13 with initial AML and 2 with relapsed or refractory AML. 12 cases of FLAG consolidation 2 courses, 3 cases consolidation 3 courses. Mobilization program: 9 cases of FLAG, 6 cases of high doses of etoposide (VP16) + G-CSF. The results showed that 11 (73.3%) of 15 patients were confirmed to have sufficient hematopoietic stem cells (2.0 × 106 / kg) and 3.52 × 106 / kg [(2.2-4.6) × 106 / kg], only enough mononuclear cells (MNC) were collected in 4 cases, but the content of CD34 + cells was lower.Conclusion: The 2-treatment FLAG consolidation therapy has no obvious effect on the hematopoietic stem cells in AML patients, and the side effects are not obvious And does not affect the mobilization of autologous peripheral blood stem cells.