吲哚美辛对干扰素α-2b联合小剂量阿糖胞苷治疗慢性粒细胞白血病的影响  

Influence of indomethacin on the effect of interferon alpha-2b combined with low dose cytarabine on chronic myeloid leukemia

作　　者：阮力[1] 向群[1] 谢爱辉[1] 周红波[1] 舒更新[1] 

机构地区：[1]湖南省怀化医学高等专科学校附属铁路医院怀化市第五人民医院血液病室,418000

出　　处：《白血病．淋巴瘤》2012年第8期484-486,共3页Journal of Leukemia & Lymphoma

摘　　要：目的探讨吲哚美辛对干扰素a-2b（IFNa-2b）联合小剂量阿糖胞苷（LD-Ara-c）治疗慢性粒细胞白血病慢性期（CML-CP）患者的影响。方法22例CML．CP患者按随机数字表法分为2组，对照组10例，用IFNa-2b300万u，皮下注射，隔日1次，连用3～18个月，Ara-C、30mg／d缓慢静脉滴注，10d为1个疗程，间歇2周，WBC≥20×10^9／L时，用羟基脲控制；WBC〈20×10^9／L时停用。治疗组12例，在IFN使用当天增加吲哚美辛25mg3次／d，其他治疗与对照组相同。两组均以血液学完全缓解为观察终点，比较两组WBC开始下降时间、WBC降至正常所需时间、外周血幼稚细胞达正常所需时间、达血液学完全缓解所需时间和注射IFN前3d最高体温。结果治疗组和对照组WBC开始下降时间分别为（4．2±2．7）d和（5．0±2．5）d（t=0．714，P〉0．05），WBC降至正常所需时间分别为（10．0±4＋5）d和（12．0±4．5）d（t=1．036，P〉0．05）；治疗组和对照组外周血幼稚细胞达正常所需时间分别为（14．2±4．8）d和（19．0±3．6）d，差异有统计学意义（t=2．609，P〈0．02）；治疗组和对照组达血液学完全缓解所需时间分别为（45.8±5．6）d和（53．9±10．5）d，治疗组优于对照组（t=2．314，P〈0．05）。两组注射IFN后发热程度治疗组改善显著优于对照组（x2=12．041，P〈0．005）。结论吲哚美辛与IFN a-2b联合LD—Am—c治疗CML—CP，不仅能缓解IFN流感样不良反应而且有协同抗白血病作用。Objective To investigate the influence of indomethacin to the unite treatment effect on chronic phase myeloid leukemia （CML-CP） with interferon alpha-2b （IFNa-2b） and low dose cytarabine （LD-Ara-C）. Methods 22 CML-CP patients were randomly divided into two groups. Control groups （10 cases） injected with IFN a-2b （3 million units）, injection frequency was q.o.d, the duration of treatment was about 3-18 months, cytarabine （Ara-C） by slowly intravenous driped （30 mg/d）. In this treatment schedule, every course of treatment sustained 10 days, and with a 2 weeks interval. During this process, patients in treatment group were treated with hydroxyl urea only when their WBC in peripheral blood exceed 20×10^9/L, otherwise, discontinue it. Treatment group （12 cases）, on the first day of treatment with IFN a-2b and Ara-C, added indomethacin （25 mg） through oral administration, the frequency was t.i.d. During treatment in the two group, the end point of observation was completely hematology ease, at the same time, these indicators in the two groups needed to be compared, the time when WBC begin to fall, the time when WBC fall to normal range, the time when immature cells returned to normal, the time which complete hematological remission and the highest temperature of patients after IFN a-2b was subcutaneous injected. Results The time when WBC begin to fall in treatment group was （4.2±2.7） d, and the time was （5.0±2.5） d in control group （t = 0.714, P 〉 0.05）. In treatment group, the time when WBC fall to normal range was（10.0±4.5） d, and the time was （12.0±4.5） d in control group （t = 1.036, P 〉 0.05）. The time when immature cells returned to normal in treatment group was （14.2±4.8） d, and the time was （19.0±3.6） d in control group （t = 2.609, P 〈 0.02）. The time which complete hematological remission was achieved in control group was （45.8±5.6） d, but it was （53.9±10.5） d in control group （t = 2.314, P 〈 0.05）. Meanwhile,

关 键 词：白血病 髓样 慢性 吲哚美辛 药物疗法 联合 

分 类 号：R733.7[医药卫生—肿瘤]