Ohsaka A, Kano Y, Sakamoto S, Kanzaki A, Hashimoto M, Yawata Y, Miura Y
Nihon Ketsueki Gakkai Zasshi. 1989 Feb;52(1):7-17.
We analyzed hemolytic reaction following vinca alkaloid administration in patients with acute lymphoblastic leukemia, blast crisis of chronic myelogenous leukemia and malignant lymphoma in the leukemic phase. During the course of chemotherapy in which vinca alkaloids were included, indirect-form dominant hyperbilirubinemia was observed in 21 of the 31 evaluable patients. In 8 patients with hyperbilirubinemia, reticulocytosis coincided with vinca alkaloid administration. Peripheral blood films showed prominent anisocytosis in 4 patients and increased stomatocytes in 10 patients. Red cell membrane studies in patients with hemolysis revealed increased sodium transport and increased activity of Na+, K+-ATPase. These findings were considered to represent the abnormal membrane "leakiness". Thus, vinca alkaloids might induce erythrocytotoxicity, which leads to acquired stomatocytosis with hemolysis in some patients.
我们分析了急性淋巴细胞白血病、慢性粒细胞白血病急变期以及白血病期恶性淋巴瘤患者使用长春花生物碱后发生的溶血反应。在包含长春花生物碱的化疗过程中，31例可评估患者中有21例出现间接胆红素血症为主的高胆红素血症。在8例高胆红素血症患者中，网织红细胞增多与长春花生物碱给药同时出现。外周血涂片显示4例患者有显著的红细胞大小不均，10例患者有口形红细胞增多。溶血患者的红细胞膜研究显示钠转运增加以及钠钾ATP酶活性增加。这些发现被认为代表了异常的膜“渗漏”。因此，长春花生物碱可能诱发红细胞毒性，导致部分患者出现获得性口形红细胞增多伴溶血。
