Objective: To investigate the short-term and long-term curative efficacy of low-intensity traditional chemotherapy regimen for elderly patients with acute myeloid leukemia (AML, non-M3) and related adverse reactions, in order to explore whether low-intensity traditional chemotherapy regimen still has application value in the treatment of elderly AML patients today.
Methods: The clinical characteristics, treatment response and prognosis of 67 elderly patients with AML (non-M3) admitted to our hospital from June 2008 to December 2018 were retrospectively analyzed. All patients received low-intensity conventional chemotherapy (i.e. lower standard dose, and without new drugs listed in China since the 21st century), including DA, HA, CAG, etc. The CR rate, median survival time and 5-year cumulative survival rate of patients were evaluated, and the related indexes were compared with the data reported in domestic and foreign literatures at the same time.
Results: The CR rate was 55.2% (37/67), the median survival time was 13.7 months, and the 5-year cumulative survival rate was (24.4±6.3)% in patients received low-intensity tradional chemotherapeutic regimens. The CR rates of high-risk group and non-high-risk group were 38.7% (12/31) and 69.4% (25/36), respectively; the median survival time of high-risk group and non-high-risk group was 8.9 months and 25.2 months respectively; the 5-year cumulative survival rate of high-risk group was (10.2±6.6)% and that of non-high-risk group was (36.0± 9.4)%. Compared with the data reported in the literature at the same time, the data obtained from the low-intensity traditional chemotherapy regimen for the elderly AML did not have an obvious disadvantage, morever had relatively short bone marrow suppression time, low induction early mortality rate and low incidence of severe infection.
Conclusion: At present, the low-intensity traditional chemotherapy regimen still has good curative effect and survival advantages for elderly AML patients, especially for non-high-risk patients. The adverse reactions are controllable, and the physical and economic conditions of the vast majority of patients can bear the treatment regimen.
题目: 低强度传统化疗方案治疗老年急性髓系白血病（非M3型）的疗效和患者生存情况分析.
目的: 观察低强度传统化疗方案在治疗老年急性髓系白血病（AML，非M3型）中的近期和远期疗效，以及相关不良反应，探讨低强度传统化疗方案治疗老年AML在当今是否仍有应用价值.
方法: 回顾性分析2008年6月至2018年12月在本院收治的67例老年AML患者（非M3型）的临床特点、治疗反应及预后情况。所有患者均采用低强度传统化疗方案（即低于标准剂量及未采用21世纪以来在我国上市的新药）治疗，包括DA方案、HA方案、CAG方案等，评价患者的CR率、中位生存期及5年累积生存率等指标，并与同期国内外文献报道的数据进行比较.
结果: 采用低强度传统化疗方案治疗老年AML患者的CR率为55.2%（37/67），中位生存期13.7个月，5年累积生存率（24.4±6.3）%。其中，高危组与非高危组的CR率分别为38.7%(12/31)和69.4%（25/36）；高危组与非高危组的中位生存期分别为8.9和25.2个月；高危组的5年累积生存率为（10.2±6.6）%，非高危组的5年累积生存率为（36.0±9.4）%。采用低强度传统化疗方案治疗老年AML获得的相关数据与同期文献报道的数据比较未显示出明显劣势，且骨髓抑制时间相对短、诱导早期死亡率低及重症感染发生率低.
结论: 低强度传统化疗方案在当今治疗老年AML患者仍具有不错的疗效及患者生存优势，尤其适用于非高危组AML患者，且不良反应可控，绝大多数患者的身体状况能耐受该治疗方案，且经济上能承担.