Clinical Observation of Gemcitabine Combined with Mitoxantrone and Etoposide Regimen for Relapsed or Refractory Acute Leukemia_West China Medical Journal

Authors：

LIANG Xiaogong

Department of Hematology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

Keywords：

吉西他滨; 米托蒽醌; 足叶乙甙; 诱导性化学疗法; 复发难治性急性白血病

DOI：

CNKI: 51-1356/R.20120214.1338.004

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目的　探讨吉西他滨+米托蒽醌+足叶乙甙（GME）方案诱导化学疗法（化疗）治疗复发难治性急性白血病的疗效。方法　 2010年5月－2011年4月对20例复发难治性急性白血病应用GME方案化疗，以了解其有效性、毒副反应。结果　随访7个月20例复发难治性白血病经过GME方案诱导化疗1个疗程后总反应率为50%，其中5例完全缓解，4例部分缓解，1例形态学完全缓解而血细胞计数未完全缓解，均无早期死亡患者。结论　 GME方案可作为复发难治性急性髓系白血病的一种安全、有效的诱导化疗方案，值得临床尝试。

Citation： LIANG Xiaogong. Clinical Observation of Gemcitabine Combined with Mitoxantrone and Etoposide Regimen for Relapsed or Refractory Acute Leukemia. West China Medical Journal, 2012, 27(2): 168-170. doi: CNKI: 51-1356/R.20120214.1338.004 Copy

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11.	梁效功. GMED方案诱导治疗急性淋巴细胞白血病晚期复发患者再次缓解一例[J]. 白血病·淋巴瘤, 2011, 20(7): 446-447.
12.	Schirmer M, Stegmann AP, Geisen F, et al. Lack of cross-resistance with gemcitabine and cytarabine in cladribine-resistant HL60 cells with elevated 5’-nucleotidase activity[J]. Exp Hematol, 1998, 26(13): 1223-1228.
13.	Angiolillo AL, Whitlock J, Chen Z, et al. PhaseⅡstudy of gemcitabine in children with relapsed acute lymphoblastic leukemia or acute myelogenous leukemia (ADVL0022): a children’s oncology group report[J]. Pediatr Blood Cancer, 2006, 46(2): 193-197.
14.	Steinherz PG, Seibel NL, Ames MM, et al. PhaseⅠ study of gemcitabine (difluorodeoxycytidine) in children with relapsed or refractory leukemia (CCG-0955): a report from the Children's Cancer Group[J]. Leuk lymphoma, 2002, 43(10): 1945-1950.
15.	Rizzieri DA, Bass AJ, Rosner GL, et al. PhaseⅠ evaluation of prolonged-infusion gemcitabine with mitoxantrone for relapsed or refractory acute leukemia[J]. J Clin Oncol, 2002, 20(3): 674-679.
16.	Apostolidou E, Estey E, Cortes J, et al. Mitoxantrone and prolonged infusion gemcitabine as salvage therapy in patients with acute myelogenous leukemia[J]. Leuk Res, 2003, 27(4): 301-304.
17.	Lee JH, Choi SJ, Lee JH, et al. Continuous infusion intermediate-dose cytarabine, mitoxantrone plus etoposide for refractory or early relapsed acute myelogenous leukemia[J]. Leuk Res, 2006, 30(2): 204-210.

1. Lowenberg B, Downing JR, Burneett A. Acute myeloid leukemia[J]. N Engl J Med, 1999, 341(14): 1051-1062.
2. Rowe JM. What is the best induction regimen for acute myelogenous leukemia? [J]. Leukemia, 1998, 12(Suppl 1): S16-19.
3. Robak T, Wrzesien-Kus A. The search for optimal treatment in relapsed and refractory acute myeloid leukemia[J]. Leuk Lymphoma, 2002, 43(2): 281-291.
4. Aviv I, Irit R, Jacob M, et al. Acute lymphocytic leukemia: role of hematopoietic stem cell transplantion in current management[J]. Curr Opin Hematol, 2003, 10(6): 463-468.
5. 张之南, 沈悌. 血液病诊断及疗效判断标准[M]. 3版. 北京: 科学技术出版社, 2007: 116-117.
6. 佚名. 关于难治性急性白血病诊断标准的建议(草案)[J]. 白血病·淋巴瘤, 2000, 9(1): 63.
7. Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the international working group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trial in acute myeloid leukemia[J]. J Clin Oncol, 2003, 21(24): 4642.
8. Gökbuget N, Hoelzer D. Treatment of adult acute lymphoblastic leukemia[J]. Semin Hematol, 2009, 46(1): 44-75.
9. Leopold LH, Willemze R. The treatment of acute myeloid leukemia in first relapse: a comprehensive review of the literature[J]. Leuk Lymphoma, 2002, 43(9): 1715-1727.
10. Miyawaki S, Hatsumi N, Yamauchi T. Phase 2 study of FLAGM (fludarabine+High-Dose Ara-C+G-CSF+Mitoxantrone) for relapsed or refractory acute myeloid leukemia (AML): a report frome the Japan adult leukemia study group (JALSG)[J]. Blood, 2009, 114(10): Abstract 2051.
11. 梁效功. GMED方案诱导治疗急性淋巴细胞白血病晚期复发患者再次缓解一例[J]. 白血病·淋巴瘤, 2011, 20(7): 446-447.
12. Schirmer M, Stegmann AP, Geisen F, et al. Lack of cross-resistance with gemcitabine and cytarabine in cladribine-resistant HL60 cells with elevated 5’-nucleotidase activity[J]. Exp Hematol, 1998, 26(13): 1223-1228.
13. Angiolillo AL, Whitlock J, Chen Z, et al. PhaseⅡstudy of gemcitabine in children with relapsed acute lymphoblastic leukemia or acute myelogenous leukemia (ADVL0022): a children’s oncology group report[J]. Pediatr Blood Cancer, 2006, 46(2): 193-197.
14. Steinherz PG, Seibel NL, Ames MM, et al. PhaseⅠ study of gemcitabine (difluorodeoxycytidine) in children with relapsed or refractory leukemia (CCG-0955): a report from the Children's Cancer Group[J]. Leuk lymphoma, 2002, 43(10): 1945-1950.
15. Rizzieri DA, Bass AJ, Rosner GL, et al. PhaseⅠ evaluation of prolonged-infusion gemcitabine with mitoxantrone for relapsed or refractory acute leukemia[J]. J Clin Oncol, 2002, 20(3): 674-679.
16. Apostolidou E, Estey E, Cortes J, et al. Mitoxantrone and prolonged infusion gemcitabine as salvage therapy in patients with acute myelogenous leukemia[J]. Leuk Res, 2003, 27(4): 301-304.
17. Lee JH, Choi SJ, Lee JH, et al. Continuous infusion intermediate-dose cytarabine, mitoxantrone plus etoposide for refractory or early relapsed acute myelogenous leukemia[J]. Leuk Res, 2006, 30(2): 204-210.

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Clinical Observation of Gemcitabine Combined with Mitoxantrone and Etoposide Regimen for Relapsed or Refractory Acute Leukemia

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