小剂量高三尖杉酯碱、阿糖胞苷联合G-CSF治疗急性髓细胞白血病28例临床分析

Objective: To explore the clinical effect of low dose of homoharringtonine (HHT) and cytarabine (Ara-c) combined with granulocyte colony-stimulating factor (G-CSF) (HAG regimen) in treating acute myelocytic leukemia (AML). Methods: Twenty-eight patients with AML including 3 cases of M1, 10 cases of M2a, 1 case of M2b, 2 cases of M4, 8 cases of M5 and 4 cases of myelodysplasticsyndrome (MDS) were treated with HAG regimen. HHT 1mg/d intravenous infusion and Ara-c 25~50mg/d intravenous infusion were administered from 1st to 14th day; G-CSF 150-300 μg/d was injected subcutaneously. If the white blood cell count rose to 20×10^9/L, G-CSF was suspended until the WBC dropped to normal. Results: Complete remission (CR) and partial remission (PR) were observed in 22 of the total 28 cases (78%). Among the 15 CR cases, 4 had received mitoxantrone and cytarabine, pirarubicin and cytarabine regimen for two cycles before but had achieved no remission. Ten of the 28 cases sere elderly AML (60≥years), and CR was noted in 7 of them. Conclusions: The regimen of low dose of homoharringtonine and cytarabine in combination with G-CSF is effective for patients with relapsed and/or secondary acute myeloid leukaemia, especially the elderly.