Grümayer E R, Schmidmeier W, Panzer S, Gadner H
Blut. 1986 Oct;53(4):309-14. doi: 10.1007/BF00320890.
Seventeen children and two adolescents, aged 6 months to 20 9/12 years, with poor risk leukemia were treated with a total of 38 sequential high-dose ARA-C-Asparaginase courses (HIDAC-ASNase). Each course was followed by profound myelosuppression. Fever occurred in 13.2% and infectious complications in 7.9% of courses. Other side effects were vomiting (81.6%), drug fever (55.3%), mucositis and diarrhoea (28.9%), mild hepatotoxicity (26.3%), exanthemas (18.4%), conjunctivitis (15.8%), local ASNase hypersensitivity (7.9%), athropathy (5.3%). One patient developed generalized seizures followed by coma and death. The possible association between ARA-C, the CNS symptoms and death could neither be demonstrated nor excluded. Except for the possible ARA-C related CNS toxicity, toxic effects were reversible. We consider this treatment a tolerable chemotherapeutic contribution in childhood.
17名儿童和2名青少年，年龄在6个月至20又9/12岁之间，患有高危白血病，共接受了38个连续的大剂量阿糖胞苷-门冬酰胺酶疗程（大剂量阿糖胞苷-门冬酰胺酶）。每个疗程后均出现严重的骨髓抑制。发热发生率为13.2%，感染并发症发生率为7.9%。其他副作用包括呕吐（81.6%）、药物热（55.3%）、粘膜炎和腹泻（28.9%）、轻度肝毒性（26.3%）、皮疹（18.4%）、结膜炎（15.8%）、局部门冬酰胺酶超敏反应（7.9%）、关节病（5.3%）。1例患者出现全身性癫痫发作，随后昏迷并死亡。阿糖胞苷、中枢神经系统症状和死亡之间的可能关联既无法证实，也无法排除。除了可能与阿糖胞苷相关的中枢神经系统毒性外，毒性作用是可逆的。我们认为这种治疗是儿童期可耐受的化疗方法。
