老年急性髓细胞白血病临床特点及个体化治疗疗效观察

摘要

目的：探讨老年急性髓细胞白血病( AML)的临床特点及个体化治疗效果。方法：对67例初治老年AML患者，分析其临床特点，并给予标准或亚标准剂量的DA、AA、HA、CAG等方案联合化疗或小剂量高三尖杉酯碱、小剂量阿糖胞苷单药化疗。结果：总完全缓解(CR)率为50.7%。60~69岁的患者 CR 26例(60.5%)，其中60~69岁机体状况较好组 CR 18例(69.2%)，中位生存时间15.5个月，早期病死1例；机体状况较差组CR 8例(47.1%)，中位生存时间10.3个月，早期病死3例。≥70岁患者 CR 8例(33.3%)，中位生存时间7.5个月，早期病死7例。经化疗的患者均产生不同程度的骨髓抑制。结论：老年AML患者个体化差异较大，总体缓解率低，生存时间短，化疗相关死亡率高，应采用个体化治疗提高缓解率。%Objective:To explore the clinical characteristics and individualized treatment effects of acute myelocytic leukemia( AML) in elderly patients. Methods:The clinical characteristics of 67 initial treatment elderly patients with AML were analyzed. The patients were treated with the combination with the standard doses or substandard doses of DA,AA,HA and CAG or the single chemotherapy with harringtonine or Ara-C. Results:The total complete remission(CR) rate was 50. 7 %. The CR rate of 26 cases with 60 to 69 years old was 60. 5%,which included 18 cases(69. 2%) with better physical condition(the median survival time was 15. 5 months,early death was 1 case) and 8 cases(47. 1%) with poor physical condition( the median survival time was 10. 3 months,early death was 3 cases). The CR rate of 8 cases with more than 70 years old was 33. 3%(their median survival time was 7. 5 months,early death was 7 cases) . Different degrees of bone marrow suppression in all patients were found. Conclusions:The elderly people with acute myelocytic leukemia are large difference in chemotherapy responses, low CR rate, short survival time and high death rate. The individualized treatment can improve the CR.