FLAG-IDA方案可改善高危急性髓细胞性白血病患者初始诱导缓解治疗的疗效

鲁猛.FLAG-IDA方案可改善高危急性髓细胞性白血病患者初始诱导缓解治疗的疗效[J].内科急危重症杂志,2022,28(2):117-120

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DOI：10.11768/nkjwzzzz20220207

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基金项目:河北省卫健委科研课题（No：20201252）

作者	单位	E-mail
鲁猛	廊坊市中医医院	wss8147@sina.com

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中文摘要:

目的: 分析高危急性髓细胞性白血病（AML）患者采用FLAG-IDA方案 [甲氧柔红霉素（IDA）联合氟达拉滨（Flu）、阿糖胞苷（Ara-C）和粒细胞集落刺激因子（G-CSF）]进行初始诱导缓解治疗的临床疗效及预后。方法：将2010年1月至2017年1月廊坊市中医医院急诊科诊治的80例AML患者纳入研究，采用随机数字表法将患者分为FLAG-IDA组（41例）和对照组（39例），FLAG-IDA组予甲氧柔红霉素、氟达拉滨、阿糖胞苷及粒细胞集落刺激因子进行初始诱导缓解治疗，对照组予甲氧柔红霉素联合阿糖胞苷组成的IA/DA（3+7）方案进行初始诱导缓解治疗，记录患者治疗过程中出现的不良反应，比较2组患者在第一次诱导治疗结束后的临床疗效，并在患者第一次初始诱导缓解治疗结束后对患者进行为期24个月的随访，记录患者疾病复发或进展情况，比较2组临床疗效及预后。结果：FLAG-IDA组第一次诱导治疗后的完全缓解率、总有效率、总生存率及无病生存率明显高于对照组，未缓解率明显低于对照组（P均＜0.05）；2组部分缓解率及总不良反应发生率比较，差异无明显统计学意义（P均＞0.05）。结论：FLAG-IDA方案用于高危AML患者初始诱导缓解治疗具有较好的临床疗效，且近期总生存率及无病生存率较高，无严重不良反应。

英文摘要:

Objective: To analyze the clinical efficacy and prognosis of patients with high-risk acute myeloid leukemia(AML) treated with FLAG-IDA regimen [idarubicin (IDA) combined with fludarabine (Flu), cytarabine (Ara-C) and granulocyte colony stimulating factor (C-CSF)] for initial induction remission therapy. Methods: A total of 80 AML patients diagnosed and treated in the Emergency Department of Langfang Traditional Chinese Medicine Hospital from January 2010 to January 2017 were included in the study. The patients were divided into FLAG-IDA group (41 cases) and control group (39 cases) by the random number table method. The FLAG-IDA group was treated with IDA, Flu, Ara-C and C-CSF for initial induction remission therapy, and the control group was given the IA/DA(3+7) regimen composed of IDA combined with Ara-C for initial induction remission therapy. The adverse reactions of patients during treatment were recorded, the clinical efficacy of the two groups after the first induction therapy was compared,and the patients were followed up for a period of 24 months after the first initial induction remission therapy. The disease recurrence or progression of the patients was recorded, and the clinical efficacy and prognosis were compared between the two groups. Results: The complete remission rate, total effective rate, overall survival rate and disease-free survival rate after the first induction therapy were significantly higher, and the non-remission rate was significantly lower in the FLAG-IDA group than those in the control group (both P<0.05). There was no significant difference in the partial remission rate and total adverse reaction rate between the two groups (both P>0.05). Conclusion: FLAG-IDA regimen has better clinical efficacy in the initial induced remission treatment of high-risk AML patients and higher short-term overall survival and disease-free survival rate, and there were no serious adverse reactions.