大剂量阿糖胞苷治疗儿童急性髓细胞性白血病的远期疗效  

LONG- TERM OUTCOME OF HEGH- DOSE CYTARABINE- BASED CONSOLIDATION CHEMOTHERAPY FOR CHILDHOOD WITH ACUTE MYELOGENOUS LEUKEMIA

作　　者：蒋慧[1] 陆正华[1] 杨为群[1] 杨静薇[1] 

机构地区：[1]上海交通大学附属儿童医院内科,上海200040

出　　处：《白血病．淋巴瘤》2004年第4期206-208,共3页Journal of Leukemia & Lymphoma

摘　　要：目的:应用大剂量阿糖胞苷(HDAra蛳C)在儿童急性髓细胞性白血病(AML)缓解后强化治疗,并观察远期疗效。方法:共44例AML(除M3外),其中HDAra蛳C治疗组21例(男14例,女7例),中位年龄8.58岁;对照组23例(男15例,女8例),中位年龄6.5岁;亚型:治疗组M13例,M2a8例,M2b2例,M4a4例,M4b3例,M51例;对照组:M15例,M29例,M48例,M51例。两组均给予相同方案诱导和巩固治疗后分组行骨髓抑制性强化治疗。结果:1疗程CR37/44例(84.1 %),2疗程CR 8/44例(18.1 %)。治疗组1/21例完成2疗程后失访;16/20例(80 %)CCR,其中13例(65 %)已停药2 a^5 a;2/20例(10.0 %)复发;2/20例(10.0 %)严重感染死亡;对照组3/23例失访和放弃;10/20例(50 %)完成全疗程并停药(最长15 a);9/20例(45%)复发;1例严重感染死亡。结论:HDAra蛳C在儿童AML作缓解后强化治疗,总疗程短,远期疗效好。但骨髓抑制严重,应积极预防和控制以降低治疗相关死亡率。Objective: Childhood acute myelogenous leukemia(AML) were treated with high- dose cytarabine- based (HDAra- C) consolidation and long- term outcome. Methods: 44 AML cases (expect M3) were enrolled and 21 cases(Male14, Female7) were treated with HDAra- C, mean age was 8.58 years; 23 cases (Male 15, female 8) were contrast and mean age was 6.5 years; Subtypes: 3 of M1, 8 of M2a, 2 of M2b, 7of M4 and 1 of M5 were treated with HDAra- C(2.0 g/M2, q12h×6 time). 5 of M1, 9 of M2, 8 of M4 and 1 of M5 were contrast. All of cases were given same project in inductive and consolidated therapy. Results: 37/44 cases(84.1 %)had been complete remission(CR) with one period and others had been CR with two periods. HDAra- C group: 16 of 20 cases (1 had give up after 2 Cycles) (80 %) are continuous CR(CCR), in which 13 of 16 cases(65 %) have stopped for 2 to 5 years. 2 of 20 cases(10.0 %) relapsed. 2 of 18 cases (10.0 %) died (sever infection).Contract: 3 of 23 cases had given up or lost touch with. 10 of 20 cases(50 %) have achieved all of therapy (the longest is 15 years). 9 of 20 cases (45 %) relapsed. 1 of them died of sever infection. Conclusion: HDAra- C acted as strengthen therapy after CR will decrease treated period and have good curative effect in future dates with childhood acute myelogenous leukemia, but the marrow restrain is severity and must be given active prevention in case of reducing correlated mortality.

关 键 词：大剂量阿糖胞苷 儿童急性髓性白血病 强化治疗 

分 类 号：R733.71[医药卫生—肿瘤]