Effect of fludarabine combined with cytarabine on acute myeloid leukemia / 新乡医学院学报

ABSTRACT

Objective To investigate the effect of fludarabine combined with medium dose cytarabine on acute myeloid leukemia(AML).Methods A total of 55 AML patients were selected from January 2011 to January 2016 in the First People's Hospital of Xinxiang City.Among the patients,there were 16 cases of poor response after initial induction of chemotherapy (double induction group),15 cases of first induction failure(first induction failure group) and 24 cases of relapsed and refractory AML(relapsed-refractory group).All the patients were treated with fludarabine combined with medium dose cytarabine,four weeks was a course,and after treated for two courses the therapeutic effect and survival status of the patients in the three groups were compared.Results The total effective rate in the double induction group,the first induction failure group and the relapsed-refractory group was 81.3％ (13/16),66.7％ (10/15) and 33.3％ (8/24),respectively;the total effective rate in the double induction group and the first induction failure group was significantly higher than that in the relapsed-refractory group (x2 =8.839,4.127;P ＜ 0.05),but there was no significant difference in the total effective rate between the double induction group and the first induction failure group(x2 =0.860,P ＜ 0.05).The median of disease-free survival time in the double induction group,the first induction failure group and the relapsed-refractory group was 29,21 and 10 months,respectively.The disease-free survival time in the double induction group was significantly longer than that in the first induction failure group and the relapsed-refractory grouP(x2 =9.536,33.256;P ＜ 0.05),and the disease-free survival time in the first induction failure group was significantly longer than that in the relapsed-refractory group (x2 =21.077,P ＜ 0.05).The median overall survival time in the double induction group,the first induction failure group and the relapsed-refractory group was 40,29 and 12 months,respectively.The median overall survival time in the double induction group and the first induction failure group was significantly longer than that in the relapsed-refractory group (x2 =33.686,28.649;P ＜ 0.05),but there was no significant difference in the median overall survival time between the double induction group and the first induction failure group (x2 =2.417,P ＜0.05).Conclusion Fludarabine combined with medium dose cytarabine in the treatment of AML can obtain significant curative effect,and the effect in the patients with poor response after initial induction and the first induction failure is better than that in the patients with relapsed and refractory AML.