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目的:评价老年急性白血病各型别、各年龄段及其不同治疗方案的疗效。方法:对初治的老年急性白血病84例进行临床研究,其中60 ～69 岁45 例,70 ～79 岁32 例,80 岁以上7 例;急性髓细胞性白血病( AML) 组60 例,用ADMP 方案32 例,AAG 方案19 例,小剂量Ara - C5 例,ATRA 方案4 例;急性淋巴细胞白血病(ALL) 组15 例,用DOCMP 序贯方案;AML/ MDS 组9 例,以ADMP 方案为主。结果:CR 率:AML48-3 % 、ALL53-3 % 、AML/ MDS0 ;60 ～69 岁60 % ,70 ～79 岁34-4 % ,80 岁以上0 。其中AML 组按治疗方案CR 率:ADMP 方案53-1 % ,AAG 方案42-1 % ,小剂量Ara - C 方案20 % ,ATRA 方案75 % 。结论:年龄愈大预后愈差;病型以AML 最好,ALL 次之,AML/ MDS最差。骨髓中原始细胞数< 50 % 的预后好。
OBJECTIVE: To evaluate the efficacy of different types, age groups, and different treatment options for elderly patients with acute leukemia. METHODS: A total of 84 patients with newly diagnosed acute leukemia were studied clinically, including 45 patients aged 60-69 years, 32 patients aged 70-79 years, and 7 patients aged over 80 years; 60 acute myeloid leukemia (AML) patients were treated with ADMP. Program 32 cases, 19 cases of AAG regimen, 4 cases of low-dose Ara-C5 cases, 4 cases of ATRA regimen; 15 cases of acute lymphoblastic leukemia (ALL) group, using DOCMP sequential regimen; 9 cases of AML/MDS group, mainly ADMP regimen . Results: CR rates: AML 48-3%, ALL53-3%, AML/MDS0; 60-69 years old 60 %, 70-79 years old 34-4 %, 80 years old 0. Among them, the CR rate according to the treatment regimen in the AML group was 53-1 % for the ADMP regime, 42-1 % for the AAG regimen, 20% for the low-dose Ara-C regimen, and 75% for the ATRA regimen. Conclusion: The older the age is, the worse the prognosis is; the best is AML, followed by ALL, and the worst is AML/MDS. Prognosis in the bone marrow of < 50 % is good.