Aihara M, Sasaki Y, Yoshida Y
First Department of Internal Medicine, Hirosaki University School of Medicine.
Rinsho Ketsueki. 1990 Oct;31(10):1745-9.
A 33-year-old female was diagnosed as having chronic myelocytic leukemia (CML) with Philadelphia (Ph1) chromosome and breakpoint cluster region (bcr) rearrangement. Physical examination revealed a huge splenomegaly and laboratory data showed WBC 490 x 10(3)/microliter and NAP score 44. She was treated with hydroxyurea, alpha-interferon, or busulfan, but severe adverse reaction such as skin rash, fever, and arthralgia, which allowed the therapy discontinue was occurred. When the patient was treated with the oral form of etoposide, a semisynthetic podophillotoxin, the number of leukocyte has been successfully maintained less than 10 x 10(3)/microliters at the dose of 50-100 mg/day and splenomegaly completely disappeared. Although Ph1 chromosome was unchanged in the percentage after the therapy for 5 months, etoposide may be effective agent for a chronic or accelerated phase of CML. Alopecia which was reversible and well tolerable was the only side effect of the drug.
一名33岁女性被诊断为患有伴有费城（Ph1）染色体和断裂点簇集区（bcr）重排的慢性粒细胞白血病（CML）。体格检查发现脾脏巨大，实验室检查数据显示白细胞计数为490×10³/微升，中性粒细胞碱性磷酸酶（NAP）积分为44。她接受了羟基脲、α干扰素或白消安治疗，但出现了诸如皮疹、发热和关节痛等严重不良反应，导致治疗中断。当患者接受口服半合成鬼臼毒素依托泊苷治疗时，白细胞数量成功维持在每天50 - 100毫克剂量下低于10×10³/微升，脾脏肿大完全消失。尽管治疗5个月后Ph1染色体百分比未改变，但依托泊苷可能是CML慢性期或加速期的有效药物。脱发是该药物唯一的副作用，且脱发可逆，耐受性良好。
