培门冬酶联合化疗治疗儿童急性淋巴细胞白血病疗效观察  

Short-term efficacy of polyethylene glycolconjugated asparaginase in childhood acute lymphoblastic leukemia

作　　者：韩争争[1] 郭秀彬[1] 袁平[1] 易雪岚[1] 郭义敏[1] 冒青[1] 

机构地区：[1]遵义医学院附属医院小儿内二科,贵州遵义563099

出　　处：《遵义医学院学报》2015年第5期506-508,共3页Journal of Zunyi Medical University

摘　　要：目的观察培门冬酶联合化疗治疗儿童急性淋巴细胞白血病的近期疗效和不良反应。方法 2013年4月至2014年4月经培门冬酶联合化疗的13例ALL患儿为试验组,2012年4月至2013年4月经左旋门冬酰胺酶联合化疗的15例ALL患儿为对照组,均经CCLG-ALL08方案诊治,随访1-3年。比较两组诱导缓解化疗后第33天的骨髓缓解率,治疗1年后的无事件生存率和不良反应发生率。结果两组诱导缓解化疗第33天骨髓完全缓解率均为100%,差异无统计学意义（P〉0.05）;1年无事件生存率试验组84.6%,对照组80.0%,差异无统计学意义（P〉0.05）;试验组13人共用47例次培门冬酶,不良反应发生率为23.4%,包括低蛋白血症12.8%,凝血功能异常6.4%和转氨酶升高4.3%,无过敏反应发生;对照组15人共用左旋门冬酰胺酶214例次,不良反应发生率42.1%,包括转氨酶升高17.3%,低蛋白血症11.2%,凝血功能异常8.9%,高血糖2.3%,过敏反应1.4%,胰腺炎0.9%,试验组总体不良反应发生率低于对照组,差异有统计学意义（P〈0.05）。结论培门冬酶联合化疗治疗儿童急性淋巴细胞白血病近期疗效显著,不良反应和过敏反应低于左旋门冬酰胺酶,用药次数少,利于联合化疗的按时完成。Objective To evaluate the short -term efficacy and adverse reaction of polyethylene glycolconjugated asparaginase（ PEG - Asp） in combined chemotherapy treatment of childhood acute lymphoblastic leukemia （ALL）. Methods 13 cases of childhood ALL who accepted PEG - Asp treatment as experimental group from April 2013 to April 2014, 15 cases of childhood ALL who accepted L- asparaginase（L- Asp） treatment as control group from April 2012 to April 2013 were compared. All patients in our study were treated with CCLG - ALL 08 protocol, and followed up for 1 to 3 years. Results Bone marrow complete response rate were 100% in both groups after 33 days of induced chemotherapy and there was no significant difference （P 〉 0.05 ）. One year without event survival rate in experimental group was 84.6% and in control group was 80.0%. There was no signifi- cant difference（P 〉0.05）. 13 children in the experimental group who were given 47 times PEG- Asp treatment in total. Adverse reactions rate in this group was 23.4% , including hypoalbuminemia（ 12.8% ） , blood coagulation abnormalities （6.4%） , abnormal plasma fibrinogen levels（4.3% ）. No anaphylaxis was observed. 15 chil- dren in the control group accepted 214 times L- Asp treatment in total. Adverse reactions rate in this group was 42.1%, including abnormal plasma fibrinogen levels （ 17.3% ）, hypoalbuminemia （ 11.2% ）, blood coagulation abnormalities （ 8.9% ）, hyperglycaemia （ 2.3 % ）, anaphylaxis （ 1.4% ）, pancreatitis （ 0.9 % ）. The overall inci- dence rate of adverse reaction in experimental group is lower than the control group patients （ P 〈 0.05 ）. Conclusion PEG - Asp combination chemotherapy treatment of children with acute lymphoblastic leukemia in the short - term curative effect is remarkable, and adverse reaction and anaphylaxis is lower than that of L - Asp. To compare L - Asp, PEG - Asp will be used fewer times and it can help finish combination chemotherapy treatment on time.

关 键 词：急性淋巴细胞白血病 培门冬酶 不良反应 儿童 

分 类 号：R733.71[医药卫生—肿瘤]