Takahashi I, Nakada H, Hayashi N, Sekito N, Inagaki T, Aoyama S, Nonaka K, Ohmoto E, Kobayashi Y, Uchida K
Gan To Kagaku Ryoho. 1986 Sep;13(9):2780-5.
Four cases of hypoplastic leukemia, one of acute myelocytic leukemia (M2) and one of RAEB-t were treated with a low-dose 4N-behenoyl-1-beta-D-arabinofuranosylcytosine (LD-BHAC) regimen, in which 50 mg BHAC was administered daily intravenously by one-hour drip infusion for 14 days. Among the 6 cases, three (2 hypoplastic leukemia and one M2) obtained complete remission and one (hypoplastic leukemia), partial remission. Response rates were 66.6% of all cases, and 75% of cases of hypoplastic leukemia. During treatment, cytopenia was observed in all cases and a decrease in bone marrow nucleated cell counts was recognized in the aged M2 patient with remission. Although side effects of the drug on the digestive system such as anorexia and nausea were observed in some cases, they were all controllable by conventional treatments. The serum concentration of ara-C was measured in 4 cases. The peak level of serum ara-C concentration, 3.62-18.9 ng/ml (mean: 11.74 ng/ml), was observed at the time of cessation of infusion of BHAC, and an ara-C level of 2.75-4.89 ng/ml (mean: 3.54 ng/ml) was still present in the blood 6 hours after the cessation of infusion. It was concluded that LD-BHAC was useful in the clinical management of atypical leukemia and acute myelocytic leukemia in the aged.
4例低增生性白血病、1例急性髓细胞白血病（M2）和1例难治性贫血伴原始细胞增多-转变型（RAEB-t）患者接受了低剂量4-N-硬脂酰-1-β-D-阿拉伯呋喃糖胞苷（LD-BHAC）方案治疗，即每日静脉滴注50 mg BHAC，1小时滴完，共14天。6例患者中，3例（2例低增生性白血病和1例M2）获得完全缓解，1例（低增生性白血病）获得部分缓解。所有病例的缓解率为66.6%，低增生性白血病病例的缓解率为75%。治疗期间，所有病例均出现血细胞减少，缓解的老年M2患者骨髓有核细胞计数下降。虽然部分病例观察到药物对消化系统的副作用，如厌食和恶心，但均可通过常规治疗控制。对4例患者测定了阿糖胞苷的血清浓度。BHAC输注停止时观察到血清阿糖胞苷浓度峰值水平为3.62 - 18.9 ng/ml（平均：11.74 ng/ml），输注停止6小时后血液中阿糖胞苷水平仍为2.75 - 4.89 ng/ml（平均：3.54 ng/ml）。结论是LD-BHAC在老年非典型白血病和急性髓细胞白血病的临床治疗中有效。
