临床观察的非早幼粒细胞急性髓细胞性白血病患者诱导伊达柔比星或柔红霉素包括标准方案:三级护理中心的经验。

IF 2.8 3区 医学 Q2 PHARMACOLOGY & PHARMACY BMC Pharmacology & Toxicology Pub Date : 2025-01-20 DOI:10.1186/s40360-025-00839-w
Jianhui Xu, Chaoyang Song, Yanjie He, Rui Huang, Sanfang Tu
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引用次数: 0

摘要

背景:很少有中国研究通过探索真实数据来比较依甲红霉素和柔红霉素“3+7”强化化疗对AML患者早期和长期预后的影响。患者与方法:以“3+7”方案诱导的非早幼粒细胞性AML患者为研究对象,探讨诱导反应与长期生存的相关因素。结果:与柔红霉素诱导相比,伊达红霉素诱导化疗难治率更低(10% vs 25%, P = 0.02)。但细胞遗传学分子风险分类是与初始诱导或化疗难治后实现CR相关的唯一独立因素(P = 0.000和0.036)。无论是总生存期(OS)还是无进展生存期(PFS),移植和化疗难治性都是独立的相关因素,MLL重排和DNA甲基化相关基因的突变也是独立的相关因素。移植时CR和MLL重排是与移植后OS和移植后无复发生存相关的独立因素。结论:传统“3+7”化疗方案联合阿达红霉素诱导CR效果优于柔红霉素。但患者的长期生存与临床实践方面有关,如进行干细胞移植,同样也与基因改变有关,如MLL重排和DNA甲基化相关基因的突变。
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The clinical observation of none-promyelocytic AML patients inducted with idarubicin or daunorubicin included standard regimens: a tertiary care center experience.

Background: Few Chinese study compared the impacts of idarubicin and daunorubicin based "3+7" intensive chemotherapies on early and long-term outcomes of AML patients through exploring their real-world data.

Patients and methods: Our none promyelocytic AML patients inducted with "3+7" regimens were studied to find out the factors relating with induction response and long term survival.

Results: Idarubicin induction was related with less chemotherapy refractory rate comparing with daunorubicin induction (10% vs 25%, P = 0.02). But cytogenetic molecular risk classification was the only independent factor relating with achieving CR after initial induction or chemotherapy refractory (P = 0.000 and 0.036). Both to overall survival (OS) and progress free survival (PFS), having transplantation and chemotherapy refractory were independent factors related, MLL rearrangement and DNA methylating related genes' mutations as well. CR at time of transplantation and MLL rearrangement were independent factors relating both with OS after transplantation and relapse free survival after transplantation.

Conclusion: Traditional "3+7" chemotherapy regimen with idarubicin plays better in CR induction than that with daunorubicin. But the patient's long-term survival related with clinical practice aspects, like having stem cell transplantation, as well as genetic alterations equally, like MLL rearrangement and DNA methylating related genes' mutations.

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来源期刊
BMC Pharmacology & Toxicology
BMC Pharmacology & Toxicology PHARMACOLOGY & PHARMACYTOXICOLOGY&nb-TOXICOLOGY
CiteScore
4.80
自引率
0.00%
发文量
87
审稿时长
12 weeks
期刊介绍: BMC Pharmacology and Toxicology is an open access, peer-reviewed journal that considers articles on all aspects of chemically defined therapeutic and toxic agents. The journal welcomes submissions from all fields of experimental and clinical pharmacology including clinical trials and toxicology.
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