Arakawa Yuki, Koh Katsuyoshi, Aoki Takahiro, Kubota Yasuo, Oyama Ryo, Mori Makiko, Hayashi Mayumi, Hanada Ryoji
Department of Hematology/Oncology, Saitama Children's Medical Center.
Rinsho Ketsueki. 2014 Nov;55(11):2316-9.
Clofarabine, one of the key treatment agents for refractory and relapsed acute lymphoblastic leukemia (ALL), achieves a remission rate of approximately 30% with single-agent clofarabine induction chemotherapy. However, a remission rate of approximately 50% was reported with a combination chemotherapy regimen consisting of clofarabine, etoposide, and cyclophosphamide. We treated two cases with refractory and relapsed ALL with combination chemotherapy including clofarabine; one was an induction failure but the other achieved remission. Both cases developed an infectious complication (NCI-CTCAE grade 3) and body pain with infusion. Prophylactic antibiotic and opioid infusions facilitated avoiding septic shock and pain. Further investigation of such cases is required.
氯法拉滨是难治性和复发性急性淋巴细胞白血病（ALL）的关键治疗药物之一，单药氯法拉滨诱导化疗的缓解率约为30%。然而，据报道，由氯法拉滨、依托泊苷和环磷酰胺组成的联合化疗方案的缓解率约为50%。我们用包括氯法拉滨在内的联合化疗治疗了2例难治性和复发性ALL患者；1例诱导失败，但另1例实现了缓解。2例患者均出现感染性并发症（美国国立癌症研究所常见不良反应事件评价标准3级）和输液时的身体疼痛。预防性使用抗生素和阿片类药物输注有助于避免感染性休克和疼痛。对此类病例需要进一步研究。
