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背景与目的:含有蒽环类抗生素的方案已经成为了治疗急性髓性白血病的标准治疗。本研究以米托蒽醌方案为对照,探讨了含有吡喃阿霉素(perarubicin,THP)的联合化疗方案在年轻急性髓性白血病的患者治疗中的疗效与毒性。方法:129例初治急性髓性白血病入组,年龄≥16岁而<60岁,诱导化疗给予常规剂量的阿糖胞苷及THP或米托蒽醌(MIT)。完全缓解(CR)后,患者接受两个疗程的原诱导方案的化疗;此后,交替应用含有THP及MIT的方案进行巩固治疗,三周一个疗程,共四个疗程。在持续缓解的情况下,维持治疗共三年。结果:在42例接受THP诱导缓解治疗的患者中,26例(61.90%)患者达到CR;73例以MIT作为诱导缓解治疗的患者中,有48例(65.75%)达到CR。两者比较,无显著的统计学意义(P>0.05)。在THP进行诱导治疗的患者中,9例(34.61%)患者在一年内出现复发;而MIT治疗的患者其一年内的复发率为22.92%;但经统计分析后发现,两者之间无统计学意义(P=0.28)。对诱导化疗中两种方案阿糖胞苷(Ara-C)加THP或Ara-C加MIT的副作用进行比较发现,除脱发发生率THP组(26.19%)低于MIT组(42.47%)外(P<0.01),其它毒副反应如感染、恶心、呕吐及心脏事件,发生率几乎相同(P>0.05)。结论:THP加Ara-C的方案能够用于年轻成人的初治白血病的诱导化疗,但其并不优于含有MIT的方案;在完全缓解后,THP和MIT可用于巩固治疗中。
Background and Objectives: Anthracycline-containing regimens have become the standard treatment for acute myeloid leukemia. In this study, the mitoxantrone regimen was used as a control to investigate the efficacy and toxicity of combined chemotherapy regimens containing perarubicin (THP) in the treatment of patients with acute myeloid leukemia. Methods: A total of 129 patients with newly diagnosed acute myeloid leukemia were enrolled in the study. Patients aged ≥16 years and <60 years old underwent induction chemotherapy with conventional doses of cytarabine and THP or mitoxantrone (MIT). After complete remission (CR), the patient receives two courses of chemotherapy with the original induction regimen; thereafter, the regimen with THP and MIT is alternately used to consolidate the treatment, three courses a week for a total of four courses. In the case of sustained remission, treatment was maintained for a total of three years. RESULTS: Of the 42 patients who underwent THP-induced remission, 26 (61.90%) achieved CR; 73 (65.75%) of 73 patients who received MIT as induction remission achieved CR. There was no significant difference between the two groups (P> 0.05). Nine patients (34.61%) had recurrence within one year in THP induction therapy, while the recurrence rate in MIT patients was 22.92% within one year; however, after statistical analysis, there was no statistical difference between the two Significance of learning (P = 0.28). The side effects of two regimens of Ara-C plus THP or Ara-C plus MIT in induction chemotherapy were found to be lower than those in the MIT group (26.19%) except for the incidence of hair loss P <0.01). The incidences of other side effects such as infection, nausea, vomiting and cardiac events were almost the same (P> 0.05). CONCLUSIONS: THP plus Ara-C regimen can be used in the induction chemotherapy of first-line leukemia in young adults, but it is not superior to the regimen containing MIT; THP and MIT can be used in consolidation therapy after complete remission.