Lyman G H, Williams C C, Preston D
N Engl J Med. 1980 Jan 31;302(5):257-60. doi: 10.1056/NEJM198001313020503.
To investigate whether lithium ameliorates the infectious complications that accompany systemic chemotherapy, we studied 45 patients with small-cell bronchogenic carcinoma receiving combination chemotherapy and radiation therapy. Twenty received lithium carbonate, and 25 received no additional therapy. Control subjects experienced more days with neutropenia than the lithium-treated group (2.17 days per 100 patient-days vs. 0.29), more severe febrile episodes (seven patients vs. one patient), more days hospitalized with fever and neutropenia (1.92 per 100 patient-days vs. 0.18), and more infection-related deaths (five vs. none). Infection-free survival was significantly longer in the lithium-treated group than in controls (P less than 0.05). Delay in subsequent chemotherapy was longer (P less than 0.01) and the number of dose reductions greater (P less than 0.01) in the control group. For both leukocytes and neutrophils, the first cycle nadir, mean of all treatment nadirs, and the lowest nadir observed during treatment were significantly higher in the lithium group. Mean mid-cycle monocyte counts were greater in the lithium group (P less than 0.05) and correlated with concurrent serum lithium levels (rs = 0.74, P less than 0.05). We believe that lithium carbonate shows promise as a means of lowering the risk of infection among patients receiving cytotoxic therapy.
为了研究锂是否能改善全身化疗伴随的感染并发症，我们对45例接受联合化疗和放射治疗的小细胞支气管癌患者进行了研究。20例患者接受碳酸锂治疗，25例患者未接受额外治疗。对照组患者出现中性粒细胞减少的天数比锂治疗组更多（每100患者日2.17天 vs. 0.29天），更严重的发热发作（7例患者 vs. 1例患者），因发热和中性粒细胞减少住院的天数更多（每100患者日1.92天 vs. 0.18天），以及更多与感染相关的死亡（5例 vs. 0例）。锂治疗组的无感染生存期明显长于对照组（P小于0.05）。对照组后续化疗的延迟时间更长（P小于0.01），剂量减少的次数更多（P小于0.01）。对于白细胞和中性粒细胞，锂组第一个周期的最低点、所有治疗最低点的平均值以及治疗期间观察到的最低最低点均明显更高。锂组的平均周期中期单核细胞计数更高（P小于0.05），并且与同期血清锂水平相关（rs = 0.74，P小于0.05）。我们认为碳酸锂有望作为降低接受细胞毒性治疗患者感染风险的一种手段。
