Uzuka Y, Saito Y
Third Dept. of Internal Medicine, Tohoku University School of Medicine.
Gan To Kagaku Ryoho. 1991 Apr;18(4):571-8.
We demonstrated the clinical effectiveness of combination therapy with Busulfan and Bestatin in 13 patients with Philadelphia chromosome positive chronic myelogenous leukemia, including 9 in chronic phase and 4 in acute phase. Sequential cytogenetic studies and molecular analysis of the breakpoint cluster regions were performed every 2 months. Complete hematologic remissions were observed in all 13 patients. Five minor cytogenetic responses, 2 partial cytogenetic remissions and 2 complete cytogenetic remissions were observed. All of the 4 patients in early chronic phase achieved cytogenetic remission and in 3 of them there was a complete disappearance of rearranged restrictive fragments of the bcr gene. In contrast, 4 of the 5 patients in late chronic phase failed to achieve cytogenetic remission and only 1 achieved minor cytogenetic response, suggesting excellent effects, particularly in patients with early disease. It is clear from this pilot study that combining Bestatin with Busulfan is an effective way to reduce or eliminate Ph1 positive clone and to maintain this status.
我们证明了白消安与贝司他汀联合治疗对13例费城染色体阳性慢性粒细胞白血病患者的临床有效性,其中9例处于慢性期,4例处于急性期。每2个月进行一次连续的细胞遗传学研究和断裂点簇集区域的分子分析。13例患者均观察到完全血液学缓解。观察到5例微小细胞遗传学反应、2例部分细胞遗传学缓解和2例完全细胞遗传学缓解。4例早期慢性期患者均实现细胞遗传学缓解,其中3例bcr基因重排限制性片段完全消失。相比之下,5例晚期慢性期患者中有4例未实现细胞遗传学缓解,仅1例实现微小细胞遗传学反应,表明疗效显著,尤其是对早期疾病患者。从这项初步研究可以清楚地看出,贝司他汀与白消安联合使用是减少或消除Ph1阳性克隆并维持该状态的有效方法。