三氧化二砷治疗老年急性髓系白血病临床观察.docVIP

三氧化二砷治疗老年急性髓系白血病临床观察[摘要] 目的：探讨三氧化二砷治疗老年急性髓系白血病的疗效。方法：选取我科2005年1月～2010年1月住院的急性髓系白血病患者（非M3型）22例（治疗组），应用三氧化二砷治疗2个疗程，并与同期20例（对照组）应用DA方案进行联合化疗的患者作比较。比较两组的缓解率、不良反应发生情况。结果：治疗组完全缓解率为31.82%，有效率为59.09%；对照组完全缓解率为30.00%，有效率为65.00%，两组疗效差异无统计学意义(P＞0.05)。但治疗组的不良反应发生率明显低于对照组（P＜0.05）。结论：三氧化二砷治疗老年急性白血病疗效可靠、不良反应少，患者耐受性好。 [关键词] 三氧化二砷 急性白血病 老年人 [中图分类号] R733.71[文献标识码]Ａ [文章编号]1673-7210（2011）02（c）-029-02 Clinical observation of Arsenic Trioxide in treatment of senile acute myeloid leukemia ZHANG Ying, FAN Hua (Department of Hematology， the Center Hospital of Jinzhou City, Jinzhou 121000, China) [Abstract] Objective: To explore clinical effect of Arsenic Trioxide on senile acute myeloid leukemia. Methods: 22 senile patients with acute myeloid leukemia were allocated in treatment group, they accepted the treatment of Arsenic Trioxide. Another 20 senile patients were allocated in control group, they accepted DA combined chemotherapy. Complete remission rate and adverse reactions of two groups were compared. Results: Complete remission rate of treatment group was 31.82%,effective rate was 59.09%; those of control group were 30.00% and 65.00% respectively, there were no difference between them (P＞0.05). But there was significant difference between adverse reactions (P＜0.05). Conclusion: Therapeutic effect of Arsenic trioxide for senile acute leukemia is good and adverse reaction is little， patients can better tolerated. [Key words] Arsenic Trioxide；Acute myeloid leukemia; Elderly people 老年急性白血病（AML）指年龄≥60岁患者所患的白血病。近年来，老年急性白血病的发病率有所上升。老年AML患者因年龄大、既往疾病多、不良免疫分型及不良核型表达率高、对化疗耐受性差等特点，故其完全缓解率及长期存活率较低[1]。又因化疗后骨髓抑制期长、抑制程度严重，故死亡率较高[2]。目前的治疗手段包括小剂量化疗、减量的联合化疗及姑息化疗等疗效差，不良反应大，患者常无法耐受。我院应用三氧化二砷治疗此病患者22例，效果满意，现报道如下： 1 资料与方法 1.1 研究对象 选取我科2005年1月～2010年1月住院的急性髓系白血病患者（非M3型）22例为治疗组，其中男13例，女9例；年龄60～82岁，中位年龄72岁；M1 1例，M2 9例，M4 4例，M5 6例，M6 2例；有骨髓增生异常综合征病史者5例；曾有高血压及冠心病5例，慢性阻塞性肺疾病1例，糖尿病4例，肾功能不全1例。对照组中，男11例，女9例；年龄61～79岁，中位年龄70岁；其中M1 1例，M2 8例，M4 2例，M5 6例，M6 1例；有骨髓增生异常综合征病史者2例。曾有高血压及冠心病4例，慢性