Esumi N, Todo S, Arakawa S, Imashuku S
Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 1):951-8.
Combination chemotherapy consisting of etoposide and cytosine arabinoside (Ara-C) was given to 38 children with hematological malignancy. They included 18 patients with acute lymphocytic leukemia (ALL), two with non-Hodgkin's lymphoma (NHL), one with myeloproliferative disorder (MPD), and one with histiocytic medullary reticulosis (HMR), all of whom had relapsed or not responded to initial treatment. Sixteen patients with nonlymphocytic leukemia (ANLL), 13 in remission, two in relapse, and one in induction failure, were also studied. The drug combination was administered by intravenous infusion twice a week for two consecutive weeks at a dosage of 150 mg/m2 for each drug. Among the 18 patients with ALL, seven complete responses and three partial responses were achieved. Six of the seven complete responders relapsed at 0.5-3 months, and the remainder has been in remission for 2.5+ months. None of the patients with refractory ANLL, NHL, MPD or HMR achieved complete remission; however, two of three ANLL patients and one HMR patient demonstrated partial response. Among the 13 ANLL patients in remission, 9 patients have continued remission for more than 4 months with a median of 26+ months, ranging from 6+ months to 40+ months, while 4 relapsed within 4 months after the administration of this regimen. The toxic effects were tolerable. Results indicate that an etoposide and Ara-C combination is effective especially in refractory ALL in childhood.
对38例血液系统恶性肿瘤患儿采用依托泊苷和阿糖胞苷（Ara-C）联合化疗。其中包括18例急性淋巴细胞白血病（ALL）患儿、2例非霍奇金淋巴瘤（NHL）患儿、1例骨髓增殖性疾病（MPD）患儿和1例组织细胞性髓性网状细胞增生症（HMR）患儿，所有这些患儿均已复发或对初始治疗无反应。还对16例非淋巴细胞白血病（ANLL）患儿进行了研究，其中13例处于缓解期，2例复发，1例诱导失败。药物组合通过静脉输注给药，每周两次，连续两周，每种药物剂量为150mg/m²。在18例ALL患儿中，7例获得完全缓解，3例获得部分缓解。7例完全缓解者中有6例在0.5 - 3个月时复发，其余患儿缓解期达2.5个月以上。难治性ANLL、NHL、MPD或HMR患儿均未获得完全缓解；然而，3例ANLL患儿中的2例和1例HMR患儿表现出部分缓解。在13例处于缓解期的ANLL患儿中，9例持续缓解超过4个月，中位缓解期为26个月以上，范围从6个月以上至40个月以上，而4例在该方案给药后4个月内复发。毒性作用可耐受。结果表明，依托泊苷和阿糖胞苷联合用药尤其对儿童难治性ALL有效。
