奈拉滨治疗2例成人复发/难治性T淋巴细胞白血病的疗效并文献复习  

Curative effect of nelarabine in 2 cases of adult relapsed/refractory T-cell acute lymphoblastic leukemia and review of the literatures

作　　者：于锦香[1] 李艳[1] 王晓雪[1] 王萍萍[1] 蔡大利[1] 

机构地区：[1]中国医科大学附属第一医院血液科,沈阳110001

出　　处：《实用药物与临床》2013年第4期311-314,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察奈拉滨治疗成人复发/难治性T淋巴细胞白血病的疗效及不良反应。方法奈拉滨1 500 mg/(m2.d)静滴2 h(第1、3、5天),21 d为1个疗程。1例复发性T-ALL给予2个疗程,1例难治性T-ALL给予1个疗程。结果 1例复发T-ALL在第1个疗程后获完全缓解伴不完全血象恢复(CRi),继续应用奈拉滨1个疗程后获CR。但4个月后疾病再次复发。8个月后死于急性心肌梗塞。另1例难治性T-ALL应用1个疗程后无治疗反应,停用奈拉滨,应用其他联合化疗后获CR,已行异基因造血干细胞移植,病情稳定。2例患者均出现Ⅲ～Ⅳ级血液学不良反应,Ⅰ～Ⅱ级神经系统毒性,Ⅰ级消化道反应,1例出现轻度肝功异常。无奈拉滨治疗相关死亡。结论奈拉滨用于治疗复发/难治性T淋巴细胞白血病,疗效尚可,不良反应可以耐受,可作为T-ALL治疗的一个新选择。Objective To assess the efficacy and safety of nelarabine treatment for adult relapsed/refractory T- cell acute lymphoblastic leukemia. Methods Nelarabine was administered at a dose of 1500 mg/（ m2·d ） for 2 h iv drop on the I st, 3rd and 5th day, cycles were repeated every 21 d. One patient with relapsed T-ALL accepted 2 cycles.Another patient with refractory T-ALL was given only 1 cycle. Results The relapsed T-ALL patient obtained CRi after one cycle, and achieved CR after two cycles. He relapsed after 4 months again, and died of acute myocardial infarction after 8 months. The refractory T-ALL patient was non-responding. He had received allogeneic stem-ceil transplantation after CR1 by other chemotherapy regimen. Conclusion Nelarabine is active as a single agent in adult relapsed T-ALL with acceptable toxicity. No toxicity-related death on treatment is observed. Nelarabine may provide an alternative chemotherapeutic approach for T-ALL patients.

关 键 词：奈拉滨 复发 难治性T淋巴细胞白血病 成人 

分 类 号：R733.7[医药卫生—肿瘤]