Strupp C, Knipp S, Hartmann J, Gattermann N, Haas R, Germing U
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany.
Leuk Lymphoma. 2007 Jun;48(6):1161-6. doi: 10.1080/10428190701332449.
We examined the efficacy of bendamustine in 15 pretreated patients (12 men, 3 women, median age 69 years) with acute myeloid leukaemia (AML) or myelodysplastic syndromes (MDS) 3 AML, 5 sAML, 5 CMML II, 1 RAEB II. Patients belonged to the following cytogenetic groups: 3 complex abnormal karyotypes, 7 normal karyotypes, 1 case with 20q- as sole anomaly and 4 single aberrations. The patients received in median two cycles of bendamustine (range 1-5) with a dose of 100 mg/m(2) at Day 1 + 2 (repeated after 28 days). Nine of 15 patients had no side effects of the treatment, six patients suffered from vomiting and epigastric pain as adverse effects of bendamustine. According to the IWG criteria, no complete remission or reduction of transfusions frequency have been observed. Three patients showed no response, one patient with AML died due to progressive disease. In 11 of 12 patients with initial leukocytosis (median 68,975 microl(-1), range 24,000-149,000 microl(-1)), a significant reduction of leukocytosis was achieved with bendamustine with a median duration of 4 weeks. In summary, treatment with bendamustine in patients with high-risk MDS or sAML with leukocytosis can result in a significant reduction of leukocytes, but fails to achieve hematological responses or improvement of transfusions dependency.
我们研究了苯达莫司汀对15例经预处理的急性髓系白血病（AML）或骨髓增生异常综合征（MDS）患者（12例男性，3例女性，中位年龄69岁）的疗效，其中3例AML，5例继发性AML（sAML），5例慢性粒-单核细胞白血病II型（CMML II），1例难治性贫血伴原始细胞增多II型（RAEB II）。患者属于以下细胞遗传学组：3例复杂异常核型，7例正常核型，1例以20号染色体长臂缺失（20q-）为唯一异常，4例单一畸变。患者接受中位两个周期的苯达莫司汀治疗（范围1 - 5个周期），第1天和第2天剂量为100 mg/m²（28天后重复）。15例患者中有9例无治疗副作用，6例患者出现呕吐和上腹部疼痛等苯达莫司汀的不良反应。根据国际工作组（IWG）标准，未观察到完全缓解或输血频率降低。3例患者无反应，1例AML患者因疾病进展死亡。12例初始白细胞增多的患者（中位值68,975/μl，范围24,000 - 149,000/μl）中，11例使用苯达莫司汀后白细胞增多显著降低，中位持续时间为4周。总之，苯达莫司汀治疗高危MDS或伴有白细胞增多的sAML患者可导致白细胞显著减少，但未能实现血液学缓解或改善输血依赖情况。
