米托蒽醌联合治疗儿童难治性复发性急性白血病的临床疗效观察  

Clinical observation of children patients with recurrent primary refractory acute leukemia treated combination with mitoxantrone

作　　者：屠立明[1] 张健[1] 沈亦逵[1] 

机构地区：[1]广东省人民医院儿科,广州510080

出　　处：《白血病．淋巴瘤》2006年第3期205-206,共2页Journal of Leukemia & Lymphoma

摘　　要：目的观察总结米托蒽醌(MTZ)联合治疗儿童难治性复发性急性白血病(RRAL)的疗效。方法RRAL12例,急性淋巴细胞白血病(ALL)9例,急性髓细胞性白血病(AML)3例;ALL用VMLP/Dex方案(长春新碱、米托蒽醌、左旋门冬酰胺酶、泼尼松/地塞米松)2～4周;AML用MAE方案(米托蒽醌、阿糖胞苷、依托泊苷)或大剂量阿糖胞苷+依托泊苷。结果9例ALL,CR7例,PR1例,1例未复查;3例AML,CR2例,NR1例。总CR率为81.8%(9/11),总有效率90.9%(10/11)。用药后骨髓抑制较明显,大部分病例ANE≤0.1×109/L持续1～2周,轻微肝功能损害,未见药物相关的心脏损害。结论MTZ不失为治疗RRAL的有效药物之一,用药后要注意预防和治疗骨髓抑制后出现的各种感染和出血。Objection To observe and summarize the efficiency of combination chemotherapy with mitoxantrone（MIT） for children patients with recurrent primary refractory acute leukemia（RRAL）. Methods Total 12 patients of RRAL, 9 ALL and 3 AML. We undertook VMLP/Dex （ VCR, MIT, L-ASP, prednisone / dexamethason） scheme 2-4 weeks for ALL and undertook MAE （ MIT, Ara-C, VP16 ） scheme and HD Ara-C＋ MIT for AML as induction treatment. Results 7 cases of ALL got complete recovery （ CR ） and 1 case got partial recovery （ PR ）,2 cases of AML got CR and 1 still non-recovery （ NR ）. The total rate of CR was 9/11 （ 81.8 % ） and valid rate was 10/11 （90.9 % ）.Vomiting and inhibition of bone marrow （ BM ） were main toxicity side effects. The inhibition of BM was severe and continued 1-2 weeks with ANE ≤0.1×10^9/L in most patients. Some got severe infection and hemorrhage. Most patients suffered from light hepatic function damage and none got cardiac damage that related to the drug. Conclusions MIT is one of the effective drugs for treating the recurrent primary refraction acute leukemia in children. MIT inhibit the BM severely with some long period. So when using this drug, it is must cautious to prevent and cure various severe complications.

关 键 词：米托葸醌 难治性复发性急性白血病 

分 类 号：R733.71[医药卫生—肿瘤]