Objective:To study the theprapeutic effect of patient with acute myeloid leukemia in remission treated with intermediated - dose arabinoside and fludarabine ( FA regimen). Methods: Twenty - five cases in treatment group of consolidation chemotherapy were treated with FA regimen,fludarabine phosphate 30mg/( m2 · d) ,d1-3 ,cyt-arabine( Ara -C)(1.0-2. 0) g/ql2h × 3d. Another 25 cases in control group were treated with conventional treatment regimen. Results; MRD decreased gradually and the recurrence rate for 3 years was 48% in FA group,the clinical efficacy was superior than control group (P < 0.05). Major toxicity of FA regimen was myelosuppression, grade Ⅳ hematologic toxicity occurred in all patients,nonhematology complications sonsisted of gastrointestinal side effects, mucositis,liver toxicity,which were mild to moderate and could be alleviated with supportive therapy. Conclusion: FA regimen is an important regimen for acute non - lymphocytic leukemia, which may remove residual leukemiam cells in remission and prevent central nervous system leukemia. It has light sides and fast metabolism.%目的:观察中剂量阿糖胞苷联合氟达拉滨(FA方案)在急性非淋巴细胞白血病巩固化疗中的疗效.方法:治疗组采用FA方案巩固化疗,Flu 30mg/( m2·d)d1-3,Ara-c(1.0-2.0)g/q12h×3d,对照组采用常规剂量化疗方案,比较两组的不良反应,应用FCM以白血病细胞(leukemiam cell,LC)特异分化抗原为标志监测两组残留病灶(minimal residual disease,MRD),并与传统骨髓形态学结果进行比较.结果:FA方案组MRD逐渐减少,3年复发率48％,对照组3年复发率64％,且容易出现髓外复发,两组差异率有统计学意义(P＜0.05).所有FA方案组患者均发生Ⅳ级骨髓抑制现象,明显强于对照组(P＜O.05),其他非血液系统不良反应包括胃肠道反应、黏膜炎、肝功能损伤；大多数不良反应能被患者耐受,FA组与对照组无显著差异.结论:FA方案可以清除缓解后残留的白血病细胞,又能预防中枢白血病,不良反应轻,体内代谢快,在急性非淋巴细胞白血病巩固化疗中具有重要的作用.
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