儿童急性淋巴细胞白血病诱导缓解及维持期治疗中左旋门冬酰胺酶副作用的比较  

Side Effects of L-asparaginase during Therapies for Remission Induction and Maintenance in Children with Acute Lymphocytic Leukemia

作　　者：王弘[1] 李丹 李佳特[1] 王秀丽[1] 郝良纯[1] 

机构地区：[1]中国医科大学附属盛京医院儿科,辽宁沈阳110004 [2]锦州市妇婴医院儿科,辽宁锦州121000

出　　处：《中国实验血液学杂志》2009年第3期739-741,共3页Journal of Experimental Hematology

摘　　要：本研究采用回顾性方法分析左旋门冬酰胺酶(L-ASP)在儿童急性淋巴细胞性白血病(ALL)治疗过程中可能发生的副作用,以探索L-ASP副作用的发生与患儿所处治疗阶段的关系,以便采用有效的监测手段减少副作用的发生,提高化疗安全性及患儿的长期存活率。对38例处于诱导缓解期患儿与40例处于维持期加强治疗患儿在应用L-ASP时的相关副作用发生率及程度进行了比较。结果表明:过敏反应、高血糖症及药物性肝炎的发生率在维持期加强治疗的ALL患儿高于诱导缓解期患儿,而低纤维蛋白原血症、凝血异常、胰腺炎、低蛋白血症、胃肠道反应及合并感染性休克等副作用在诱导缓解期患儿中发生率高。结论:L-ASP在使用过程中有相关副作用的发生,尤其在诱导缓解期ALL患儿中的发生率较高,应引起重视,定期全面监测可有效减少和避免副作用的发生,提高化疗的安全性。This study was purposed to investigate the possible side effects of L-asparaginase （L-ASP） in the treatment of patients with acute lymphoblastic leukemia （ALL） and to explore the corelation of these side effects at different therapeutic stages by means of retrospective analysis, so as to reduce the incidence of side effects and improve the safety of chemotherapy and the long-term survival of patients. The probability and severity of side effects related to use of L-ASP in 38 cases of ALL during remission induction therapy （VDLDex regimen） and 40 cases of ALL during maintenance intensive therapy （VMLDex regimen） were compared. The results showed that allergic response, diabetes and drug-induced liver disease happened more frequently during maintenance therapy than during remission induction therapy, while defibrination, abnormal hemaglutinin, acute pancreatitis, hypoproteinemia, gastrointestinal reaction and infectious shock were observed more during remission induction therapy than those at maintenance therapy. In conclusion, the L-ASP showed some side effects especially for the patients during the remission induction therapy which should be paid enough attention. The regular and comprehensive monitoring can effectively reduce and avoid the side effects of L-ASP, to improve the safety of chemotherapy.

关 键 词：左旋门冬酰胺酶 急性淋巴细胞性白血病 儿童 诱导缓解 维持治疗 

分 类 号：R733.71[医药卫生—肿瘤] R979.1[医药卫生—临床医学]