替尼泊苷为主的联合方案治疗难治性复发性急性白血病的疗效及多药耐药基因的表达  

Treatment of refractory relapsing acute leukemia with teniposide and cytarabine combined chemotherapy and study on influence of expression of multidrug resistance gene on therapeutic efficacy

作　　者：艾辉胜[1] 王桂林[1] 杜耀斌[1] 刘惠兰 黄士敏[1] 程锡元[1] 马海英[1] 张石[1] 

机构地区：[1]军事医学科学院附属医院

出　　处：《军事医学科学院院刊》1997年第4期265-268,共4页Bulletin of the Academy of Military Medical Sciences

基　　金：全军"九五"医学科研基金

摘　　要：用替尼泊苷（威猛，ＶＭ－２６）为主的联合方案治疗了３０例难治性复发性急性白血病并用链亲和素胶体金原位杂交（ＩＳＨ－ＳＡＧ）研究了多药耐药基因（ｍｄｒ－１）表达对疗效的影响。３０例病人中完全缓解１５例（ＣＲ），部分缓解（ＰＲ）５例，ＣＲ率５０．０％，有效率６６．７％。２１例检测了ｍｄｒ－１基因表达，其中ｍｄｒ－１阳性者７１．４％，阴性者２８．６％。ｍｄｒ－１阳性组ＣＲ率２６．７％，阴性组ＣＲ率８３．３％（Ｐ＜０．０５）。１５例ｍｄｒ－１基因阳性病人中，加用环孢素Ａ逆转治疗者的ＣＲ率５０％，未用逆转治疗者的ＣＲ率１２．５％。Thirty cases of refractory relapsing acute leukemia were treated with teniposide(VM 26) and cytarabine combined chemotherapy. The multidrug resistance gene (mdr 1) expression was also examined by streptavidin gold in situ hybridization in 21 of the 30 cases. The results showed that 15 patients got complete remission (CR rate 50.0%) and 5 cases got partial remission (PR rate 16.7%). Of the 21 leukemia patients receiving mdr1 gene examination, 15 cases (71.4%) were strongly positive for the mdr 1 gene and 6 cases (28.6%) were negative. The CR rate showed significant difference (P<0.05) between the 15 cases with mdr1 gene positive ( 26.7 %) and 6 cases with mdr 1 gene negative (83.3%). Six of 15 cases with mdr 1 positive also received the treatment with cyclosporin A (CSA) and 50% of them got CR which was better than the other 9 cases who expressed the mdr 1 gene and did not receive the CSA treatment (CR rate 11.1%).

关 键 词：白血病 AL 药物疗法 替尼泊苷 抗肿瘤药 

分 类 号：R733.710.5[医药卫生—肿瘤] R979.1[医药卫生—临床医学]