培门冬酶和左旋门冬酰胺酶治疗儿童急性淋巴细胞白血病的临床分析  

Clinical characterizations of pegaspargase and L-asparaginase in treatment of children with acute lymphoblastic leukemia

作　　者：张静静[1] 张惠琴[1] 陶小娟[1] 卢星辰[1] 党荣[1] 孙新[1] 

机构地区：[1]第四军医大学西京医院儿科,西安710032

出　　处：《山西医科大学学报》2017年第5期485-488,共4页Journal of Shanxi Medical University

摘　　要：目的探讨培门冬酶(polyethylene glycol conjugated asparaginase,PEG-ASP)和左旋门冬酰胺酶(L-asparaginase,L-ASP)在儿童急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)中疗效。方法回顾性分析第四军医大学西京医院2010-01-01~2015-01-01 88例初发的ALL患儿的临床资料,在诱导缓解期随机接受L-ASP治疗42例,PEG-ASP治疗46例,比较两组患儿临床疗效及不良反应。结果 PEG-ASP组与L-ASP组患儿诱导治疗的完全缓解(complete remission,CR)率比较(88.6%vs 87.8%),差异无统计学意义(P>0.05)。PEG-ASP组对骨髓抑制程度重于L-ASP组,且对骨髓抑制持续时间长于L-ASP组(均P<0.05)。PEG-ASP组后续发生中枢神经系统白血病(central nervous system leukemia,CNSL)比例显著低于L-ASP组(6.82%vs 24.39%,P<0.05)。PEG-Asp组患儿凝血功能障碍持续时间[(8.65±3)d]长于L-ASP组[(7.52±2.16)d](P<0.05)。两组其余不良反应方面比较,差异均无统计学意义(P>0.05)。结论 PEG-ASP治疗时,骨髓抑制、血常规、血凝恢复正常时间长,余不良反应发生率与L-ASP相似,PEG-ASP可作为儿童ALL一线治疗的选择。Objective To explore the efficacy of pegaspargase（ PEG-ASP） and L-asparaginase（ L-ASP） in children with acute lymphoblastic leukemia（ ALL）. Methods Clinical data of 88 patients with first-episode ALL were retrospectively analyzed in Xijing Hospital of Fourth Military University from January 2010 to January 2015. Of 88 patients,42 patients were treated with L-ASP,and 46 patients were treated with PEG-ASP during the induction remission period. The clinical efficacy and adverse reactions were compared between the two groups. Results The complete remission（ CR） rate was 88. 6% and 87. 8% in PEG-ASP group and L-ASP group,respectively（ P 〉 0. 05）. The bone marrow suppression degree in PEG-ASP group was more severe than that in L-ASP group,and the duration of bone marrow suppression was significantly longer（ P 〈 0. 05）. The incidence of central nervous system leukemia in L-ASP group was significantly lower than that in PEG-ASP group（6. 82% vs 24. 39%,P 〈 0. 05）. The duration of coagulation dysfunction in PEG-ASP group[（8. 65 ± 3） d] was longer than that in L-ASP group[（7. 52 ± 2. 16） d]（ P 〈 0. 05）. There was no significant difference in the other adverse reactions between the two groups（ P 〉 0. 05）. Conclusion The recovery time of blood routine,blood clotting routine and bone marrow proliferation inhibition in PEG-ASP group are longer than those in L-ASP group. The incidence of other adverse effects in two groups are similar. PEG-ASP can be used as the first-line treatment for ALL children.

关 键 词：急性淋巴细胞白血病 培门冬酶 左旋门冬酰胺酶 

分 类 号：R733.7[医药卫生—肿瘤]