亚砷酸联合沙利度胺治疗慢性髓细胞白血病加速期临床分析  

Clinical analyse of Arsenic trioxide combined with Thalidomide in the treatment of patiens with chronic myelocytic leukemia during accelerated phase

作　　者：常保萍[1] 张海深[1] 王东生[1] 任萍[1] 朱丽英[1] 赵变锋[1] 王波[1] 

机构地区：[1]河南科技大学第二附属医院血液科,河南洛阳471000

出　　处：《河南医学研究》2007年第3期227-229,共3页Henan Medical Research

摘　　要：目的：探讨亚砷酸联合沙利度胺治疗慢性髓细胞白血病加速期的有效性和安全性。方法：24例CML加速期患者入组，并被分为对照组和治疗组；对照组11例：小剂量HA化疗：高三尖衫酯碱（HHT）2-3 mg/d/m^2×7 d，阿糖胞苷（Ara-C）50-100 mg/d/m^2×7 d；每月一次。治疗组13例：在对照组用药基础上，同时加用沙利度胺和亚砷酸。沙利度胺每晚睡前口服，初始剂量100 mg/d，然后每周剂量递增50 mg/d，3周后达最高剂量200 mg/d，第4周起改维持剂量100-200 mg/d；亚砷酸10mg/d，ivgtt，qd，亚砷酸结束后15分钟维生素C 3g/d，ivgtt，qd，每周五次，用4周休2周为一疗程，共用4个疗程，所有患者共计观察168天。结果：治疗组：完全缓解2例，部分缓解4例，好转5例，无效2例，有效率84.6%；对照组：完全缓解1例，部分缓解1例，好转3例，无效6例，有效率45.5%；两组有效率与附加染色体比较有显著性差异（P〈0.05），两组Ph染色体比较无显著性差异（P〉0.05）；治疗组不良反应轻微，可以耐受。结论：亚砷酸联合沙利度胺治疗慢性髓细胞白血病加速期的有效率高，患者耐受性良好。Objective： To evaluate the safety and efficacy of Arsenic trioxide combined with Thalidomide for the treatment of patiens with chronic myelocytic leukemia during accelerated phase. Methods： 24 patiens with chronic myelocytic leukemia during accelerated phase were enrolled and were divided into 2 groups： therapy group and control group. 11 patiens in control group ： Low dosage of HA Chemotherapy. Homoharring- tonineInjection（HHT） 2 -3 mg/d/m^2 ×7 d, Cytarabine （ Ara- C） 50 -100 mg/d/m^2 ×7 d, once every month. 13 patiens in therapy group：on the base of control group administered, adding Thalidomide and Arsenic trioxide. The initial dose of Thalidomide was 100 mg/d, then increased 50 mg/d every week until 200 mg/d （The maximal dose） ,the maintain dose was 100 -200 mg/d; During 4 weeks of each 6-week cycle,Arsenic tri- oxide was administered 10mg/d, followed by as corbic acid 3g, iv gtt,for days 1-5/w. All patients maintain treatment 4 cycles （ 168 days）. Results： In therapy group,11（ 2 CR, 4 PR, 5HI） of 13 patients had an objective response （84.6%） , In control group,5（ 1 CR,1PR,3 HI） of 11 patients had an objective response （45.5%） ;The efficiency and add chromosomes compared in two groups have marked difference （ P 〈 0.05 ） , but the Ph chromosomes was no difference （ P 〉 0.05 ） , The side effect In therapy group was gently. Conclusion： Arsenic trioxide combined with Thalidomide for the treatment of patiens with chronic myelocytic leukemia during accelerated phase was efficient and side effect was tolerable.

关 键 词：亚砷酸 沙利度胺 治疗 慢性髓细胞白血病 加速期 

分 类 号：R557[医药卫生—血液循环系统疾病]