培门冬酶治疗成人急性淋巴细胞白血病的疗效及安全性  

Efficacy and safety of pegaspargase in the treatment of adult acute lymphoblastic leukemia

作　　者：沈绿瑛[1] 林聪猛[1] 林达义 

机构地区：[1]福建省漳州市医院血液科,福建漳州363000

出　　处：《中国医药科学》2017年第17期75-78,共4页China Medicine And Pharmacy

摘　　要：目的观察培门冬酶(PEG-ASP)治疗成人急性淋巴细胞白血病(ALL)的疗效和安全性。方法选择我院2010年5月~2016年7月115例初治成人急性淋巴细胞白血病患者,分析其临床资料,并进行统计。其中PEG-ASP一线治疗患者54例为PEG-ASP组,左旋门冬酰胺酶(L-ASP)一线治疗患者61例为L-ASP组。比较两组患者的治疗效果,统计指标包括完全缓解(CR)率、无进展生存(PFS)率、总生存(OS)率,对比两组治疗方案的安全性。结果 PEG-ASP组与L-ASP组患者诱导治疗完全缓解率分别为51.85%和47.54%,无进展生存率分别为72.00%和69.64%,总生存率分别为92.00%和89.29%,两组患者完全缓解率、无进展生存率以及总生存率比较差异无统计学意义(P>0.05);在安全性方面,两组患者骨髓抑制和消化道不良反应发生率差异无统计学意义(P>0.05),但PEG-ASP组患者过敏反应和肝功能损伤发生率显著低于L-ASP组(P<0.05)。结论培门冬酶作为治疗成人急性淋巴细胞白血病一线药物,其治疗效果与L-ASP相当,但含PEG-ASP的治疗方案引起肝功能损伤和过敏反应的不良反应的概率更低,在成人ALL治疗方面具有更好的临床应用前景。Objective To observe the efficacy and safety of Pegaspargase （PEG-ASP） in the treatment of adult acute lymphoblastic leukemia （ALL）. Methods 115 patients with acute lymphoblastic leukemia from May 2010 to July 2016 were enrolled in this study. Their clinical data were analyzed and statistically analyzed. Among them, 54 patients with PEG-ASP were treated with PEG-ASP group, and 61 patients with L-ASP were treated with L-ASP group. The effects of complete remission （CR）, progression-free survival （PFS） and total survival （OS） were analyzed and compared between the two groups. The safety of the two groups was compared, Results The complete remission rate of PEG-ASP group and L-ASP group were 51.85% and 47.54% respectively, and the progression-free survival rates were 72.00% and 69.64% respectively. The overall survival rates were 92.00% and 89.29% respectively. There was no significant difference in complete remission rate, progression-free survival rate and overall survival rate between the two groups （P ~ 0.05）. There was no significant difference in the incidence of bone marrow suppression and gastrointestinal adverse reactions between the two groups （P 〉 0.05）. However, the incidence of allergic and hepatic injury in PEG-ASP group was significantly lower than that in L-ASP group （P 〈 0.05）. Conclusion Pegaspargase is the first-line drug for the treatment of acute lympboblastic leukemia in adults. The therapeutic effect is similar to that of L-ASP, but the treatment with PEG-ASP is less likely to cause adverse effects of liver injury and allergic reaction. Aduh ALL treatment has a better clinical application prospects.

关 键 词：成人急性淋巴细胞白血病 培门冬酶 化疗 安全性 

分 类 号：R733.71[医药卫生—肿瘤]