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目的 :探讨羟基喜树碱联合阿糖胞苷 (CA)方案治疗高危组慢性粗细胞白血病 (CGL)的近、远期临床疗效。方法 :用CA方案治疗 18例Sokal危险指数 >1.2的慢性期高危组CGL ,观察其近远期临床疗效并与羟基脲 (Hu) +CS30 0 0单采治疗组进行对比 ;观察病人染色体治疗前后的Ph阳性细胞百分率变化情况。结果 :CA组获CR4例 (2 2 .2 % ) ,PR 6例 (33.3% ) ,总有效率为 5 5 .5 % ,1例病人获轻度细胞遗传学反应 :对照组无人CR(0 % ) ,PR 5例 (2 2 .7% ) ,总有效率 2 2 .7% ,无病人获细胞遗传学反应 ;两组间CR率及有效率均存在统计学差异 ,P <0 .0 5。CA组病人平均、中位生存期 (32 .2月、30 .0月 )稍长于对照组 (2 9.7月、2 8.0月 ) ,但无统计学差异 (P >0 .0 5 )。该方案毒副反应轻 ,病人耐受良好。结论 :羟基喜树碱联合阿糖胞苷治疗高危慢性期慢性粒细胞白血病有一定疗效 ,值得进一步在临床中观察和总结。
Objective: To investigate the short-term and long-term clinical effects of hydroxycamptothecin combined with cytarabine (CA) in the treatment of high-risk group of chronic myelocytic leukemia (CGL). Methods: 18 cases of chronic CGL group with Sokal risk index> 1.2 were treated with CA regimen. The curative effect in short-term and long-term was observed and compared with that in the Hu + CS30 0 monotherapy group. Ph positive cell percentage changes. Results: There were 4 cases (22.2%) in CR group and 6 cases (33.3%) in PR group, with a total effective rate of 55.5%. One case had mild cytogenetic response: no CR in control group 0%), PR 5 cases (22.7%), the total effective rate of 22.7%, no patient was cytogenetic response; CR rate and efficiency between the two groups were statistically significant, P <0. 0 5. The mean and median survival of patients in CA group (32.2 months and 30.0 months) was slightly longer than that of control group (2.9 months and 28.0 months), but there was no significant difference (P> 0.05). The program side effects of light, patients are well tolerated. Conclusion: Hydroxycamptothecin combined with cytarabine in the treatment of high-risk chronic myeloid leukemia has a certain effect, it is worth further clinical observation and summary.