FLAG方案治疗复发/难治急性白血病的疗效分析

目的分析FLAG方案治疗复发/难治急性白血病的疗效,观察其不良反应。方法应用FLAG方案[氟达拉滨30 mg/（m2.d）,静滴30分钟以上,第1-5天;Ara-c 2 g/（m^2.d）,氟达拉滨后4小时,维持4小时以上,第1-5天;G-CSF300μg/d,d0至中性粒细胞恢复至〉0.5×109/L]治疗15例复发/难治急性白血病,分析疗效和安全性。结果 10例达完全缓解,1例部分缓解,4例未缓解,完全缓解率66.7%,总有效率为73.3%。10例完全缓解患者除1例行异基因造血干细胞移植后失访,1例缓解后行亲缘异基因造血干细胞移植,目前仍处于缓解期,余8例均在1年内复发,中位时间7.1月（4-12月）。不良反应主要为骨髓抑制,其余非血液学反应不明显。结论 FLAG方案对复发/难治急性白血病的疗效较好,不良反应尚可耐受,可用于复发/难治急性白血病,并为造血干细胞移植创造机会,但其远期疗效尚不确定,需进一步研究。

FLAG regimen in treatment of relapsed/refractory acute leukemia

Objective To investigate the efficacy and diverse effect of FLAG regimen in the treatment of relapsed/refractory acute leukemia.Methods Fifteen patients with relapsed/refractory acute leukemia were treated with FLAG regimen.The patients received intravenous infusion of fludarabine [30 mg/（m2·d） over 30 min] and Ara-C [2 g/（m2·d） over 4 h] for 5 d;subcutaneous injections of G-CSF（300 μg/d） were given,starting 1 d prior to chemotherapy and continuing until neutrophil reached over 0.5×109/L.Results Ten out of 15 patients achieved CR,one patient achieved PR and four were nonresponsive,with the CR rate of 66.7% and the overall effective rate of 73.3%.The toxicity was mainly bone marrow suppression.Conclusion The FLAG regimen is effective and well tolerated by most patients with relapsed/refractory acute myeloid leukemia;The regimen offers an opportunity for hematopoietic stem-cell transplantation.