Kawamura S, Mikami T, Iwamura H, Sawada Y, Yamaya T, Haneda Y, Sakata Y, Chiba Y, Yoshida Y
First Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
Biomed Pharmacother. 1987;41(9-10):462-7.
Nineteen patients with acute leukemia, who achieved complete remission between January, 1980 and March, 1983, were given 10 mg of methotrexate (MTX) and 20 mg of prednisolone (PSL) intrathecally at 1st, 3rd, 6th, 10th and 15th month after the termination of consolidation therapy followed by the same dose twice a year, when the intensification therapy was being performed. During the observation period of 29 to 68 months, none developed central nervous system (CNS) leukemia. On the other hand, the incidence of CNS leukemia in patients given the prophylactic intrathecal treatment once or twice just after the complete remission was 35% (7/20) compared with 24% (8/33) in patients without treatment. No statistical difference was observed in these groups. The intrathecal administration of MTX and PSL is easy to perform and no adverse reaction was observed in our series. It is concluded that the intermittent prophylaxis with MTX and PSL is of benefit in preventing CNS leukemia in adults patients with acute leukemia.
1980年1月至1983年3月期间达到完全缓解的19例急性白血病患者，在巩固治疗结束后的第1、3、6、10和15个月接受鞘内注射10毫克甲氨蝶呤（MTX）和20毫克泼尼松龙（PSL），随后在进行强化治疗时每年两次给予相同剂量。在29至68个月的观察期内，无一例发生中枢神经系统（CNS）白血病。另一方面，完全缓解后仅接受1次或2次鞘内预防性治疗的患者中CNS白血病的发生率为35%（7/20），而未接受治疗的患者中这一发生率为24%（8/33）。这些组之间未观察到统计学差异。MTX和PSL的鞘内给药操作简便，在我们的系列研究中未观察到不良反应。得出结论，MTX和PSL的间歇性预防对预防成人急性白血病患者的CNS白血病有益。
