摘要
目的 探索采用大剂量阿糖胞苷（HD—AraC）治疗儿童急性髓系白血病（AML）的远期疗效。方法 以HD-AraC为主的联合方案作为儿童AML长期化疗中的早期和定期强化治疗，采用Kaplan-Metier法统计长期无病生存（DFS）率。采用综合措施防治强烈化疗后并发症。采用高效液相色谱法（HPLC）测定血浆和脑脊液中Ara-C浓度。结果 16例初治患者的6年以上DFS率达到62．5％（10／16例）；持续完全缓解5年以上7例，3～5年2例。但复发病例疗效仍不理想。采用积极的化疗并发症防治措施，患儿均能够度过骨髓抑制期，未出现重要脏器明显损伤和化疗相关死亡。HPLC检测显示HD-AraC治疗可以明显提高血浆和脑脊液中Ara—C浓度。结论 以HD-AraC为主的联合方案治疗儿童AML可进一步提高远期疗效，患儿能够耐受该化疗方案的强度，值得临床应用。
Objective To study the long-term therapeatic effect of high-dose Ara-C （HD-AraC） based protocols on childhood acute myeloblastic leukemia （AML）. Methods HD-AraC based protocols were used as early and regular intensification regimens to treat childhood AML, and the long-term disease free survival （DFS） rate was calculate with Kaplan-Merier method. Comprehensive procedures were proceeded to protect and treat the chemotherapy related complications. Concentration of Ara-C in plasma and cerebrospinal fluid （CSF） was determined by HPLC. Results More than 6 years DFS rate was achieved to 62.5% （10/16） in 16 newly diagnosed cases,7 cases got continuous complete remission （CCR） for more than 5 years and 2 for 3 to 5 years, but the outcomes were not good in relapsed cases. By using the comprehensive procedures to protect and treat the intensive chemotherapy related complications, all patients recovered from bone marrow suppression after intensive chemotherapy, and there was no evident side-effects could be found and no chemotherapy related death appeared. The study showed that the concentration of Ara-C in plasma and CSF could be significandy elevated by HD-AraC therapy. Conclusion The HD-AraC based protocols can improve the long-term DFS rate of childhood AML, and childhood patients can tolerate the insensitivity of the chemotherapy.
出处
《现代医学》
2007年第2期115-118,共4页
Modern Medical Journal
关键词
髓系白血病
儿童
大剂量阿糖胞苷
疗效
药物浓度
acute myeloblastic leukemia
children
high-dose Ara-C
therapeutic effect
drug concentration
