目的:评价地西他滨结合CAG方案治疗老年复发难治性急性髓细胞白血病效果和药物不良反应.方法:回顾性分析2013年01月至2015年05月扬州大学附属泰兴医院血液科收治的12例老年复发难治性急性髓细胞白血病患者的临床资料,地西他滨结合CAG方案:地西他滨20mg/m2,静滴,第1~5天;阿克拉霉素20mg/m2,第1天、第3天、第5天、第7天;阿糖胞苷10mg/m2,1次/12小时,皮下注射,第1~14天;粒系集落刺激因子300μg,皮下注射,1次/天(依照骨髓抑制情况而调整用药剂量及用药次数).结果:12例患者均出现不同程度的骨髓抑制,在骨髓抑制期间,4例出现不明原因的发热,3例出现肺部感染,1例出现肛周感染,经升白细胞、抗感染治疗后症状得到控制,1例患者肝功能损害,经保肝降酶治疗后恢复,2例出现轻度胃肠道反应,经对症治疗后症状消失.12例病人中,完全缓解者6例,部分缓解3例,总有效率为75%.结论:地西他滨联合CAG方案治疗老年复发难治性急性髓细胞白血病效果确切、临床用药安全,在临床上可以推广应用.%Objective:To evaluate the effects and adverse reactions of decitabine in combination with the CAG regimen for senile relapse refractory acute myelogenous leukemia.Methods:A retrospective analysis of 12 cases of senile relapse clinical data in patients with refractory acute myelogenous leukemia was made.The scheme of decitabine in combination with the CAG:Decitabine 20mg/m2,static drop,d1~5;Accra 20mg/m2,d1,d3,d5,d7;Cytarabine 10mg/m2,1 time/12h,subcutaneous injection,d1~14;Granulocyte colony stimulating factor 300μg,subcutaneous,1 time/d(adjust the dosage and drug use frequency in accordance with bone marrow suppression).Results:12 patients had different degree of bone marrow suppression,during the period of bone marrow suppression,4 cases had fever of unknown origin,3 cases with lung infection,1 case of Crissum infection,after eukogenic action and anti-infection treatment,infection was controlled,1 case with liver function damage,by the liver enzyme recovery after treatment,2 cases with mild gastrointestinal reaction,the symptoms disappeared after symptomatic treatment.In 12 patients,6 cases completely alleviated,3 cases were partial remission,the total effective rate was 75%.Conclusion:The effect of decitabine and CAG combination regimen for refractory acute myelogenous leukemia is effective and asfe.
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