吉西他濱聯合米托蒽醌及足葉乙甙方案誘導治療復發難治性白血病的臨床療效觀察_《華西醫學》

作者：

梁效功

綿陽市中心醫院血液科（四川綿陽，621000）;

關鍵詞：

吉西他濱米托蒽醌足葉乙甙誘導性化學療法復發難治性急性白血病

DOI：

CNKI: 51-1356/R.20120214.1338.004

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目的　探討吉西他濱+米托蒽醌+足葉乙甙（GME）方案誘導化學療法（化療）治療復發難治性急性白血病的療效。方法　 2010年5月－2011年4月對20例復發難治性急性白血病應用GME方案化療，以了解其有效性、毒副反應。結果　隨訪7個月20例復發難治性白血病經過GME方案誘導化療1個療程后總反應率為50%，其中5例完全緩解，4例部分緩解，1例形態學完全緩解而血細胞計數未完全緩解，均無早期死亡患者。結論　 GME方案可作為復發難治性急性髓系白血病的一種安全、有效的誘導化療方案，值得臨床嘗試。

引用本文： 梁效功. 吉西他濱聯合米托蒽醌及足葉乙甙方案誘導治療復發難治性白血病的臨床療效觀察. 華西醫學, 2012, 27(2): 168-170. doi: CNKI: 51-1356/R.20120214.1338.004 復制

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4.	Aviv I, Irit R, Jacob M, et al. Acute lymphocytic leukemia: role of hematopoietic stem cell transplantion in current management[J]. Curr Opin Hematol, 2003, 10(6): 463-468.
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11.	梁效功. GMED方案誘導治療急性淋巴細胞白血病晚期復發患者再次緩解一例[J]. 白血病·淋巴瘤, 2011, 20(7): 446-447.
12.	Schirmer M, Stegmann AP, Geisen F, et al. Lack of cross-resistance with gemcitabine and cytarabine in cladribine-resistant HL60 cells with elevated 5’-nucleotidase activity[J]. Exp Hematol, 1998, 26(13): 1223-1228.
13.	Angiolillo AL, Whitlock J, Chen Z, et al. PhaseⅡstudy of gemcitabine in children with relapsed acute lymphoblastic leukemia or acute myelogenous leukemia (ADVL0022): a children’s oncology group report[J]. Pediatr Blood Cancer, 2006, 46(2): 193-197.
14.	Steinherz PG, Seibel NL, Ames MM, et al. PhaseⅠ study of gemcitabine (difluorodeoxycytidine) in children with relapsed or refractory leukemia (CCG-0955): a report from the Children's Cancer Group[J]. Leuk lymphoma, 2002, 43(10): 1945-1950.
15.	Rizzieri DA, Bass AJ, Rosner GL, et al. PhaseⅠ evaluation of prolonged-infusion gemcitabine with mitoxantrone for relapsed or refractory acute leukemia[J]. J Clin Oncol, 2002, 20(3): 674-679.
16.	Apostolidou E, Estey E, Cortes J, et al. Mitoxantrone and prolonged infusion gemcitabine as salvage therapy in patients with acute myelogenous leukemia[J]. Leuk Res, 2003, 27(4): 301-304.
17.	Lee JH, Choi SJ, Lee JH, et al. Continuous infusion intermediate-dose cytarabine, mitoxantrone plus etoposide for refractory or early relapsed acute myelogenous leukemia[J]. Leuk Res, 2006, 30(2): 204-210.

1. Lowenberg B, Downing JR, Burneett A. Acute myeloid leukemia[J]. N Engl J Med, 1999, 341(14): 1051-1062.
2. Rowe JM. What is the best induction regimen for acute myelogenous leukemia? [J]. Leukemia, 1998, 12(Suppl 1): S16-19.
3. Robak T, Wrzesien-Kus A. The search for optimal treatment in relapsed and refractory acute myeloid leukemia[J]. Leuk Lymphoma, 2002, 43(2): 281-291.
4. Aviv I, Irit R, Jacob M, et al. Acute lymphocytic leukemia: role of hematopoietic stem cell transplantion in current management[J]. Curr Opin Hematol, 2003, 10(6): 463-468.
5. 張之南, 沈悌. 血液病診斷及療效判斷標準[M]. 3版. 北京: 科學技術出版社, 2007: 116-117.
6. 佚名. 關于難治性急性白血病診斷標準的建議(草案)[J]. 白血病·淋巴瘤, 2000, 9(1): 63.
7. Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the international working group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trial in acute myeloid leukemia[J]. J Clin Oncol, 2003, 21(24): 4642.
8. Gökbuget N, Hoelzer D. Treatment of adult acute lymphoblastic leukemia[J]. Semin Hematol, 2009, 46(1): 44-75.
9. Leopold LH, Willemze R. The treatment of acute myeloid leukemia in first relapse: a comprehensive review of the literature[J]. Leuk Lymphoma, 2002, 43(9): 1715-1727.
10. Miyawaki S, Hatsumi N, Yamauchi T. Phase 2 study of FLAGM (fludarabine+High-Dose Ara-C+G-CSF+Mitoxantrone) for relapsed or refractory acute myeloid leukemia (AML): a report frome the Japan adult leukemia study group (JALSG)[J]. Blood, 2009, 114(10): Abstract 2051.
11. 梁效功. GMED方案誘導治療急性淋巴細胞白血病晚期復發患者再次緩解一例[J]. 白血病·淋巴瘤, 2011, 20(7): 446-447.
12. Schirmer M, Stegmann AP, Geisen F, et al. Lack of cross-resistance with gemcitabine and cytarabine in cladribine-resistant HL60 cells with elevated 5’-nucleotidase activity[J]. Exp Hematol, 1998, 26(13): 1223-1228.
13. Angiolillo AL, Whitlock J, Chen Z, et al. PhaseⅡstudy of gemcitabine in children with relapsed acute lymphoblastic leukemia or acute myelogenous leukemia (ADVL0022): a children’s oncology group report[J]. Pediatr Blood Cancer, 2006, 46(2): 193-197.
14. Steinherz PG, Seibel NL, Ames MM, et al. PhaseⅠ study of gemcitabine (difluorodeoxycytidine) in children with relapsed or refractory leukemia (CCG-0955): a report from the Children's Cancer Group[J]. Leuk lymphoma, 2002, 43(10): 1945-1950.
15. Rizzieri DA, Bass AJ, Rosner GL, et al. PhaseⅠ evaluation of prolonged-infusion gemcitabine with mitoxantrone for relapsed or refractory acute leukemia[J]. J Clin Oncol, 2002, 20(3): 674-679.
16. Apostolidou E, Estey E, Cortes J, et al. Mitoxantrone and prolonged infusion gemcitabine as salvage therapy in patients with acute myelogenous leukemia[J]. Leuk Res, 2003, 27(4): 301-304.
17. Lee JH, Choi SJ, Lee JH, et al. Continuous infusion intermediate-dose cytarabine, mitoxantrone plus etoposide for refractory or early relapsed acute myelogenous leukemia[J]. Leuk Res, 2006, 30(2): 204-210.

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吉西他濱聯合米托蒽醌及足葉乙甙方案誘導治療復發難治性白血病的臨床療效觀察

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