Willemze R, Peters W G, Colly L P
Dept. of Medicine, Leiden University Medical Center, The Netherlands.
Eur J Haematol. 1988 Nov;41(5):489-95. doi: 10.1111/j.1600-0609.1988.tb00232.x.
Increased dosages of cytosine arabinoside (Ara-C) have been shown to be active in remission induction and consolidation treatment of patients with primary refractory acute lymphoblastic leukemia (ALL) and lymphoblastic non-Hodgkin's lymphoma (lyNHL). From August 1983 to December 1986 we treated 25 patients with ALL (9) and lyNHL, stage III and IV (16), median age 22 (range 15-48 yr) with a protocol consisting of remission induction with vincristine, prednisone, adriamycine and Ara-C (1 g/m2 twice daily as 2-h infusion d1-6) and intrathecal methotrexate, followed by consolidation courses with vincristine, prednisone, adriamycine and Ara-C (3 g/m2, twice daily as 2-h infusion d1-4) and intrathecal methotrexate. Some patients received CNS and/or mediastinal irradiation. No maintenance was given. 18 patients (72%) achieved complete remission (5 of the 11 previously treated and 13 of the 14 previously untreated patients). Consolidation courses were given to 17 patients. 5 of them relapsed in the bone marrow (3), skin (1) and CNS plus bone marrow (1) at 5, 5, 6, 6 and 24 months. The duration of complete remission ranged from 5 to 51+ months; the median could not yet be calculated. Short-term intensive treatment might be a worthwhile approach for ALL and lyNHL.
已证明增加阿糖胞苷（Ara-C）剂量对原发性难治性急性淋巴细胞白血病（ALL）和淋巴细胞性非霍奇金淋巴瘤（lyNHL）患者的缓解诱导和巩固治疗有效。1983年8月至1986年12月，我们采用由长春新碱、泼尼松、阿霉素和阿糖胞苷（1 g/m²，每日2次，2小时输注，第1 - 6天）及鞘内注射甲氨蝶呤进行缓解诱导，随后用长春新碱、泼尼松、阿霉素和阿糖胞苷（3 g/m²，每日2次，2小时输注，第1 - 4天）及鞘内注射甲氨蝶呤进行巩固疗程的方案，治疗了25例ALL患者（9例）和lyNHL III期及IV期患者（16例），中位年龄22岁（范围15 - 48岁）。部分患者接受了中枢神经系统和/或纵隔照射。未进行维持治疗。18例患者（72%）获得完全缓解（11例先前接受过治疗的患者中有5例，14例先前未接受过治疗的患者中有13例）。17例患者接受了巩固疗程。其中5例分别在5、5、6、6和24个月时出现骨髓复发（3例）、皮肤复发（1例）以及中枢神经系统加骨髓复发（1例）。完全缓解持续时间为5至51 +个月；中位时间尚未能计算出来。短期强化治疗可能是ALL和lyNHL的一种值得尝试的方法。
