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目的探讨吡柔比星联合化疗治疗成人高危或难治复发急性白血病(AL)的疗效。方法研究组用吡柔比星+阿糖胞苷方案(急性髓细胞白血病)或吡柔比星+阿糖胞苷+长春新碱+泼尼松方案[急性淋巴细胞白血病(ALL)或双表型AL],对照组用米托蒽醌+阿糖胞苷或米托蒽醌+阿糖胞苷+长春新碱+泼尼松(ALL成双表型AL)方案分别治疗高危或难治复发AL各40例。除1对为有高危因素的初治病例外,其余39对均为难治或高危复治病例。结果研究组和对照组疗效相当,完全缓解率47.5%比45.0%(P>0.05);部分缓解率25%比20%(P>0.05);总缓解率72.5%比65.0%(P>0.05)。但研究组完全缓解持续时间长(528d比463d,P<0.05)。研究组骨髓抑制较对照组明显、感染发生率高(P<0.05)、血小板恢复时间较长(P<0.05)。结论以吡柔比星为主的联合化疗方案治疗高危或难治复发AL疗效较好,但骨髓抑制明显,感染发生率高。
Objective To investigate the efficacy of pirarubicin combined with chemotherapy in the treatment of adult high risk or refractory relapsed acute leukemia (AL). Methods Study groups were treated with either pirarubicin + cytarabine (acute myeloid leukemia) or pirarubicin + cytarabine + vincristine + prednisone (acute lymphoblastic leukemia (ALL) Type AL], the control group with mitoxantrone + cytarabine or mitoxantrone + cytarabine + vincristine + prednisone (ALL into the doubly phenotype AL) program were treated with high-risk or refractory relapse AL in 40 cases. In addition to a pair of newly diagnosed cases with high risk factors, the remaining 39 cases were refractory or high-risk cases. Results The response rate was 47.5% in the study group and 45.0% in the control group (P> 0.05). The partial response rate was 25% vs 20% (P> 0.05), and the overall response rate was 72.5% vs 65.0% (P> 0.05) . However, the study group completed a long time to complete remission (528d vs 463d, P <0.05). The bone marrow suppression in the study group was significantly higher than that in the control group, with a high incidence of infection (P <0.05) and longer platelet recovery time (P <0.05). Conclusion The combination of pirarubicin-based chemotherapy in high-risk or refractory relapsed AL treatment is better, but bone marrow suppression significantly, the incidence of infection is high.