Sokal J E, Gockerman J P, Bigner S H
Department of Medicine, Duke University Medical Center, Durham, NC 27710.
Leuk Res. 1988;12(6):453-8. doi: 10.1016/0145-2126(88)90110-5.
On the basis of in-vitro studies indicating that low concentrations of cytosine arabinoside exert preferential inhibition of granulocyte-macrophage colony-forming cells from patients with chronic granulocytic leukemia vs normal subjects, we treated two outpatients with low doses of this agent, administered by subcutaneous infusion for 12-31 days. Both patients continued their usual activities, including employment, during these infusions. They exhibited only Ph-positive metaphases at entry into the protocol but in both cases, Ph-positive cells were reduced to approx. 10% of marrow metaphases, after 2-3 successive infusions. Both patients exhibited significant increases in Ph-positive cells, to 46 and 72% of marrow metaphases, during subsequent chemotherapy with hydroxyurea, in dosage sufficient to maintain granulocytopenia and a normal serum B12 level. After additional cytosine arabinoside, both patients again showed decreases in Ph-positive cells, to 7% (p less than 0.01) and 19% (p less than 0.0001), respectively. This clinical experience is consistent with the conclusion that cytosine arabinoside (but not, hydroxyurea) exerts a selective antileukemic effect in some patients with CGL.
基于体外研究表明，低浓度的阿糖胞苷对慢性粒细胞白血病患者的粒细胞-巨噬细胞集落形成细胞的抑制作用比对正常受试者更具选择性，我们对两名门诊患者采用低剂量该药物进行治疗，通过皮下输注给药12 - 31天。在这些输注期间，两名患者都继续他们的日常活动，包括工作。在进入方案时，他们的骨髓中期分裂相中仅显示出Ph阳性细胞，但在两例中，经过2 - 3次连续输注后，Ph阳性细胞减少至骨髓中期分裂相的约10%。在随后用羟基脲进行化疗期间，剂量足以维持粒细胞减少和正常血清B12水平，两名患者的Ph阳性细胞均显著增加，分别达到骨髓中期分裂相的46%和72%。在再次给予阿糖胞苷后，两名患者的Ph阳性细胞再次减少，分别降至7%（p小于0.01）和19%（p小于0.0001）。这一临床经验与以下结论一致，即阿糖胞苷（而非羟基脲）在一些慢性粒细胞白血病患者中发挥选择性抗白血病作用。
