Tu Honglei, Lei Bo, Meng Shan, Liu Hailing, Wei Yongchang, He Aili, Zhang Wanggang, Zhou Fuling
Department of Clinical Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province 430071, China.
Department of Clinical Hematology, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi Province 710004, China.
Evid Based Complement Alternat Med. 2016;2016:3121402. doi: 10.1155/2016/3121402. Epub 2016 Sep 21.
We assessed the clinical effectiveness and safety of CKI (compound Kushen injection) plus standard induction chemotherapy for treating adult acute leukemia (AL). We randomly assigned 332 patients with newly diagnosed AL to control ( = 165, receiving DA (daunorubicin and cytarabine) or hyper-CVAD (fractionated cyclophosphamide, doxorubicin, vincristine, and dexamethasone)) or treatment ( = 167, receiving CKI and DA or hyper-CVAD) groups. Posttreatment, treatment group CD3+, CD4+, CD4+/CD8+, natural killer (NK) cell, and immunoglobulin (IgG, IgA, and IgM) levels were significantly higher than those of the control group ( < 0.05), and CD8+ levels were lower in the treatment group than in the control group ( < 0.05). Treatment group interleukin- (IL-) 4 and IL-10 levels were significantly higher compared to the control posttreatment (both < 0.05) as were complete remission, overall response, and quality of life (QoL) improvement rates ( < 0.05). The control group had more incidences of grade 3/4 hematologic and nonhematologic toxicity ( < 0.05). Responses to induction chemotherapy, QoL improvement, and adverse events incidence between control group patients with acute myeloid leukemia and acute lymphocytic leukemia were not significantly different. CKI plus standard induction chemotherapy is effective and safe for treating AL, possibly by increasing immunologic function.
我们评估了复方苦参注射液(CKI)联合标准诱导化疗治疗成人急性白血病(AL)的临床疗效和安全性。我们将332例新诊断的AL患者随机分为对照组(n = 165,接受柔红霉素和阿糖胞苷(DA)或改良环磷酰胺、阿霉素、长春新碱和地塞米松方案(hyper-CVAD))和治疗组(n = 167,接受CKI联合DA或hyper-CVAD)。治疗后,治疗组的CD3⁺、CD4⁺、CD4⁺/CD8⁺、自然杀伤(NK)细胞及免疫球蛋白(IgG、IgA和IgM)水平显著高于对照组(P < 0.05),而治疗组的CD8⁺水平低于对照组(P < 0.05)。治疗后,治疗组的白细胞介素-(IL-)4和IL-10水平显著高于对照组(均P < 0.05),完全缓解率、总缓解率及生活质量(QoL)改善率也显著高于对照组(P < 0.05)。对照组3/4级血液学和非血液学毒性的发生率更高(P < 0.05)。急性髓系白血病和急性淋巴细胞白血病对照组患者的诱导化疗反应、QoL改善及不良事件发生率无显著差异。CKI联合标准诱导化疗治疗AL有效且安全,可能是通过增强免疫功能实现的。