CAG／HAG预激方案治疗老年初治急性髓系白血病的临床观察

目的：观察CAG（阿克拉霉素＋阿糖胞苷＋重组人粒细胞刺激因子）/HAG（高三尖杉酯碱＋阿糖胞苷＋重组人粒细胞刺激因子）预激方案治疗老年初治急性髓系白血病（ AML）的临床疗效及不良反应。方法选取2009年6月～2014年5月期间年龄＞60岁的AML患者21例，13例采用CAG方案治疗，8例采用HAG方案治疗，同时给予成分输血等支持治疗，缓解后序贯给予DA、MA等方案交替维持治疗，观察临床疗效、不良反应及随访结果。结果21例患者中，完全缓解（CR）14例，部分缓解（PR）2例，无效（NR）5例，总有效率76．19％，主要不良反应为骨髓抑制和感染。随访至2014年8月，死亡19例（90．48％），中位生存时间13个月。结论 CAG/HAG预激方案治疗老年AML有效率高，耐受性好，值得临床推广。

Clinical observation of CAG/HAG regime for elderly treatment-naive patients with acute myeloid leukemia

Objectives To observe the therapeutic effects of CAG（ Aclacinomycin＋cytarabine＋Recombinant Human Granulo-cyte Colony-stimulating Factor）/HAG（ Homoharringtonine＋cytarabine ＋Recombinant human granulocyte colony stimulating fac-tor） ,as well as drug toxicity related side effects.Methods Between June 2009 and May 2014,21 patients aged over 60 years with acute myeloid leukemia（ AML） were recruited and treated with CAG and HAG regime,in which 13 and 8 cases were divided respec-tively.Supportive treatment such as blood component transfusion and sequential therapy of DA or MA were performed as well.Clinical efficacy,side reaction and followed-up outcomes were observed.Results Out of 21 patients,14 achieved complete remission（ CR） , 2 partial remission（ PR） ,and 5 none remission（ NR） ,with a total CR of 76.19%.Main toxic-related side effects included myelosup-pression and infection.By August 2018,19 patients were dead and median survival time was 13 months.Conclusions CAG/HAG regime is highly effective and well tolerant for patients with AML.