Gottlieb D, Bradstock K, Koutts J, Robertson T, Lee C, Castaldi P
Cancer. 1987 Oct 1;60(7):1439-41. doi: 10.1002/1097-0142(19871001)60:7<1439::aid-cncr2820600705>3.0.co;2-f.
Fifteen patients with acute myeloid leukaemia were given a total of 17 courses of high-dose cytosine arabinoside (Ara-C). The median age of the patients was 37 years. Four patients developed severe irreversible neurotoxicity, three developed mild to moderate, reversible neurotoxicity, whereas eight patients had no toxicity. Of five patients over the age of 55 years given high dose Ara-C, four developed severe, irreversible neurotoxicity, but there were no severe episodes in nine patients aged 55 years or less. (P less than 0.01). At a dose of 3 g/m2 given intravenously every 12 hours for 3 days, three cases of severe irreversible neurotoxicity were noted in elderly patients. Neurotoxicity at this total dose has previously been considered unusual. Administration of high dose Ara-C at total doses of 18 g/m2 and over carries a risk of severe irreversible cerebellar toxicity that increases with age.
15例急性髓系白血病患者共接受了17个疗程的大剂量阿糖胞苷（Ara-C）治疗。患者的中位年龄为37岁。4例患者出现严重不可逆神经毒性，3例出现轻至中度可逆性神经毒性，而8例患者无毒性反应。在接受大剂量阿糖胞苷治疗的5例55岁以上患者中，4例出现严重不可逆神经毒性，但在9例55岁及以下患者中未出现严重发作（P<0.01）。每12小时静脉注射3 g/m²，持续3天，老年患者中出现3例严重不可逆神经毒性。此前认为在此总剂量下出现神经毒性并不常见。总剂量达18 g/m²及以上的大剂量阿糖胞苷给药存在严重不可逆小脑毒性风险，且该风险随年龄增加而升高。
