文章：

急性髓系白血病中培非格司亭生长因子支持下高剂量阿糖胞苷巩固治疗压缩方案与标准方案的比较

Condensed versus standard schedule of high-dose cytarabine consolidation therapy with pegfilgrastim growth factor support in acute myeloid leukemia

原文发布日期：2017-05-26

DOI: 10.1038/bcj.2017.45

类型: Original Article

开放获取: 是

英文摘要：

The aim of this cohort study was to compare a condensed schedule of consolidation therapy with high-dose cytarabine on days 1, 2 and 3 (HDAC-123) with the HDAC schedule given on days 1, 3 and 5 (HDAC-135) as well as to evaluate the prophylactic use of pegfilgrastim after chemotherapy in younger patients with acute myeloid leukemia in first complete remission. One hundred and seventy-six patients were treated with HDAC-135 and 392 patients with HDAC-123 with prophylactic pegfilgrastim at days 10 and 8, respectively, in the AMLSG 07-04 and the German AML Intergroup protocol. Time from start to chemotherapy until hematologic recovery with white blood cells >1.0 G/l and neutrophils >0.5 G/l was in median 4 days shorter in patients receiving HDAC-123 compared with HDAC-135 (P<0.0001, each), and further reduced by 2 days (P<0.0001) by pegfilgrastim. Rates of infections were reduced by HDAC-123 (P<0.0001) and pegfilgrastim (P=0.002). Days in hospital and platelet transfusions were significantly reduced by HDAC-123 compared with HDAC-135. Survival was neither affected by HDAC-123 versus HDAC-135 nor by pegfilgrastim. In conclusion, consolidation therapy with HDAC-123 leads to faster hematologic recovery and less infections, platelet transfusions as well as days in hospital without affecting survival.

摘要翻译： 

本队列研究旨在比较急性髓系白血病首次完全缓解的年轻患者中，采用第1、2、3天给药的大剂量阿糖胞苷（HDAC-123）强化治疗方案与第1、3、5天给药方案（HDAC-135）的差异，并评估化疗后预防性使用培非格司亭的疗效。在AMLSG 07-04和德国AML协作组方案中，176例患者接受HDAC-135治疗，392例患者分别在第10天和第8天接受HDAC-123联合培非格司亭预防治疗。与HDAC-135组相比，HDAC-123组患者从化疗开始至血液学恢复（白细胞>1.0 G/L、中性粒细胞>0.5 G/L）的中位时间缩短4天（P<0.0001），而培非格司亭进一步缩短恢复时间2天（P<0.0001）。HDAC-123方案（P<0.0001）和培非格司亭（P=0.002）均显著降低感染发生率。与HDAC-135相比，HDAC-123显著减少住院天数和血小板输注需求。两种治疗方案及培非格司亭预防用药均未对生存率产生影响。结论：HDAC-123强化治疗方案能促进血液学恢复、降低感染风险、减少血小板输注和住院时间，且不影响生存结局。

原文链接：

Condensed versus standard schedule of high-dose cytarabine consolidation therapy with pegfilgrastim growth factor support in acute myeloid leukemia