| Objective:To analyze the difference of efficacy between MA and CAG induction chemotherapy in elderly patients with acute myeloid leukemia(AML).Methods:Collect the clinical data of patients from May 2012 to May 2016.There were 100 60 ? plus-year-old AML patients who was clearly diagnosed as AML in the first affiliated hospital of Zhengzhou University? 100 cases of patients,The median age 65(60-75),Men were 56 cases(56%),30 cases(30%)of patients with age > 70 years old.According to the project,46 cases with small-dose MA group,54 cases with the CAG group.first treatment :the WBC: 9.34(0.3 ~ 293.7)* 10 ^ 9/L;HGB: 81(44-148)g/L;PLT: 37.5(1 ~ 229)* 10 ^ 9 / L.the ratio of primitive bone marrow cells: 0.483(0.175 ~ 0.944).According to the FAB classification: M0 6 cases(6.0%),M1 2 cases(2.0%),M2 54 cases(54.0%),M4 6 cases(6.0%),M5 30 cases(30.0%),M6 2 cases(2.0%).According to the karyotype classification : the rito of good prognosis 4.0%;the rito of medium good prognosis 84%and the bad 4.0% respectively.NPM1 + FLT3 ITD-accounted for 10.0%(10/100);patients with FLT3 ITD +were 12%(12/100);patients with ETO + /c-Kit + were 2.0%(2/100);patients with ETO +/ c-Kit-accounted for 2.0%(2/100);c-Kit + patients accounted for 2.0%(2/100).Evaluating the effect of induction chemotherapy and analyze the factors influencing the treatment effect,observe and record the occurrence of adverse reactions.Results:(1)70(70.0%)patients after the first induction chemotherapy received remission,54(54.0%)cases received complete remission(CR),16 cases(16.0%)received partial response(PR).(2)46 cases of the small doses MA scheme,24 cases(52.2%)achieved CR,6 cases(13.0%)achieved PR,the total effective rate was 65.2%;54 cases of the CAG scheme,30(55.6%)achieved CR,10 cases(18.5%)achieved PR,the total effective rate was 71.4%,there was no statistically significant difference of CR and ORR(P =0.735 and P= 0.335),respectively.Age > 70 patients,the CR of the small dose of MA and CAG were 18.2% and 26.3% respectively(P=1.000),early mortality rates were 27.2% and 10.7% respectively(P=0.327),the difference is not statistically significant;no less than 70 years old,small doses MA group and the CAG group CR were 62.9% and 71.4% respectively(P=0.445),the early mortality rates were 0% and 0% respectively,the difference is not statistically significant.small dose of MA and the CAG induction chemotherapy in early mortality rates were 6.5% and 3.7% respectively(P=0.659),the difference is not statistically significant.(3)The affect in elderly patients with acute myeloid leukemia,according to the results of the single factor analysis of patient's age,gender,chromosome karyotype,the WHO classification,begin with platelet,hemoglobin count and the ratio of primitive bone marrow cells does not affect the curative effect of small dose of MA and the CAG induction chemotherapy treat the elderly patients with AML(P > 0.05).(4)The early death of small doses of MA group were 3 cases,2.2%(1/46)patients appeared III ~ IV degree of hemorrhage,2.2%(1/46)cases appeared III ~ IV degree of lung infection;the CAG group,The early death were 2 cases,3.7% cases(2/54)III ~ IV degree of lung infection,the differences of two groups' treatment had no statistical significance(P > 0.05).Conclusion:1.Compare to the CAG,the small-dose MA rejimen had the same effect in elderly patients with AML,and adverse reactions had not increase.2.the small-dose MA rejimen could treat elderly patients with AML... |
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