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大剂量阿糖胞苷和伊达比星巩固治疗成年急性髓系白血病患者的临床结局

Clinical outcomes with high dose cytarabine and idarubicin consolidation for adult AML patients.

作者信息

Qian Bingxin, Huang Guiqin, Cai Xiaoya, Liu Ying, Li Dengju, Yin Jin

机构信息

Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-Fang Avenue, Wuhan, 430030, China.

出版信息

Ann Hematol. 2025 Aug 25. doi: 10.1007/s00277-025-06551-3.

Abstract

High-dose cytarabine has been the frontline therapy for the consolidation treatment of acute myeloid leukemia for many years. Current guidelines suggest that the combination of anthracyclines with high-dose cytarabine can be considered an option for consolidation therapy in certain patients. However, the research in this area is limited. This study aimed to investigate whether consolidation therapy with high doses of cytarabine in combination with idarubicin could result in better long-term survival. A total of 102 patients who achieved complete response and underwent consolidated treatment more than twice were included in the analysis. In this study, 49 patients received high-dose cytarabine alone for consolidation chemotherapy (HDAC group), and 53 patients received idarubicin in combination with high-dose cytarabine for consolidation chemotherapy (IHDAC group). The use of idarubicin in combination with high-dose cytarabine in consolidation therapy did not lead to a better long-term prognosis in patients than high-dose cytarabine alone. Patients treated with idarubicin required a significantly longer time to recover from agranulocytosis during hospitalization and had a higher incidence of infections.

摘要

多年来,大剂量阿糖胞苷一直是急性髓系白血病巩固治疗的一线疗法。当前指南表明,在某些患者中,蒽环类药物与大剂量阿糖胞苷联合使用可被视为巩固治疗的一种选择。然而,该领域的研究有限。本研究旨在调查大剂量阿糖胞苷联合伊达比星进行巩固治疗是否能带来更好的长期生存。共有102例达到完全缓解且接受两次以上巩固治疗的患者纳入分析。在本研究中,49例患者接受单纯大剂量阿糖胞苷巩固化疗(HDAC组),53例患者接受伊达比星联合大剂量阿糖胞苷巩固化疗(IHDAC组)。在巩固治疗中,伊达比星联合大剂量阿糖胞苷治疗的患者相比单纯大剂量阿糖胞苷治疗并未带来更好的长期预后。接受伊达比星治疗的患者在住院期间从粒细胞缺乏症中恢复所需的时间明显更长,且感染发生率更高。

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