Aksamit A J
Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Neurovirol. 2001 Aug;7(4):386-90. doi: 10.1080/13550280152537292.
This open label study determined the outcome of non-AIDS progressive multifocal leukoencephalopathy patients treated with a standard dose of intravenous cytosine arabinoside. Nineteen patients with PML proven by brain biopsy or spinal fluid polymerase chain reaction were treated with intravenous cytosine arabinoside 2 mg/kg per day for 5 days and followed for neurologic outcome by neurologic examination and MRI scanning. Seven of 19 PML patients treated with cytosine arabinoside intravenously improved neurologically. The range of follow-up for these patients was 2.0 to 4.5 years. All were left with neurologic deficits but were functionally improved, and 6 of 7 were able to independently carry out the activities of daily living. Twelve PML patients showed no evidence of response and died rapidly of their disease after treatment (range, 8 days to 6 months). All who survived their neurologic disease recovered from treatment-induced pancytopenia. Cytosine arabinoside given intravenously to non-AIDS PML patients in this small study was associated with a 36% chance of developing stabilization at 1 year. Treatment was associated with significant bone marrow toxicity. The improvement in MRI scan changes in those patients who responded took 6 weeks or longer.
这项开放标签研究确定了接受标准剂量静脉注射阿糖胞苷治疗的非艾滋病进行性多灶性白质脑病患者的治疗结果。19例经脑活检或脑脊液聚合酶链反应证实患有PML的患者接受了静脉注射阿糖胞苷治疗，剂量为每日2mg/kg，共5天，并通过神经学检查和MRI扫描对神经学结果进行随访。19例接受静脉注射阿糖胞苷治疗的PML患者中有7例神经功能得到改善。这些患者的随访时间为2.0至4.5年。所有患者均遗留神经功能缺损，但功能有所改善，7例中有6例能够独立进行日常生活活动。12例PML患者未显示出反应迹象，治疗后迅速死于疾病（范围为8天至6个月）。所有从神经疾病中存活下来的患者均从治疗引起的全血细胞减少中恢复。在这项小型研究中，静脉注射阿糖胞苷治疗非艾滋病PML患者，1年后病情稳定的几率为36%。治疗与显著的骨髓毒性相关。有反应的患者MRI扫描变化的改善需要6周或更长时间。
