三氧化二砷联合大剂量阿糖胞苷治疗难治性白血病(附117例报告)  

Treatment of arsenic and cytosine arabinosideon refractory leukemia

作　　者：刘志胜[1] 何方[1] 

机构地区：[1]临沂市人民医院,山东临沂276003

出　　处：《山东医药》2005年第26期13-15,共3页Shandong Medical Journal

基　　金：临沂市科技局资助项目(0434023)

摘　　要：目的观察三氧化二砷(As2O3)联合大剂量阿糖胞苷(Ara-C)治疗难治性白血病的疗效和不良反应.方法将117例难治性急性粒细胞白血病患者随机分为A组(60例)和B组(57例),均给予0.1%As2O310ml+5%葡萄糖500ml中静滴(第1～30天),在此基础上,A组给予Ara-C 1.5g/(m2·d)+5%葡萄糖500ml静滴(第1～5天),B组给予柔红霉素(DNR)45mg/(m2·d)+生理盐水250ml静滴(第1～3天)及Ara-C 100mg/(m2·d)+5%葡萄糖500ml静滴(第1～7天).结果 A组完全缓解 (CR)率、长期无病生存(DFS)率,均显著高于B组;骨髓抑制程度两组比较无显著差异;黏膜损害及胃肠道损害发生率A组高于B组,但症状轻,未影响治疗.结论 As2O3联合大剂量阿糖胞苷治疗难治性白血病疗效好,不良反应轻.Objective ：To observe the efficacy and side effect of the As2O3 combined with high-dose Ara-C on refractory acute myelogenous leukemia（AML）. Methods： 117 patientes with refractory AML were randomly divided into group A （60 patients）and group B （57 patients）,all the patients were treated with 10mg As2O3 （0.1% solution）in 500ml 5% glucose solution for intravenous drip daily for 30 days. For addition group A were treated with high-dose Ara-c 1.5g/（m^2·d）for 4 days ;Group B were treated with daunorubicin 45mg/（m^2·d）for 3 days and Ara-c 100mg/（m^2·d） for 7 days. Results ： Complete remission （CR） rate of group A was 90% and the disease-free survival（DFS）at 3 years was 84%,singnificantly higher than that in the group B（P〈0. 05）. The suppression of bone marrow in group A was a little havier. The rates of damage of mucous,gastric and intesinal were singnificantly higher in group A,but easily recovered. Conclusion：As2O3 combined with high-dose Ara-C can treat refractory AML with higher CR rate and slight side effects.

关 键 词：急性粒细胞白血病 三氧化二砷 阿糖胞苷 

分 类 号：R733.7[医药卫生—肿瘤]