Willemze R, Fibbe W E, Zwaan F E
Onkologie. 1983 Aug;6(4):200-4. doi: 10.1159/000215236.
28 consecutive patients (age 15-58 years) with refractory acute leukaemia (24 AML, 4 ALL) have been treated with high or intermediate dose cytosine arabinoside (AraC). Twenty patients received AraC at a dose of 3000 mg/m2, twice daily for 6 days (13 patients AraC alone, 7 patients AraC and doxorubicin) and 8 patients received AraC at a dose of 1000 mg/m2, twice daily for 6 days and daunorubicin. 10 of the 20 patients treated with high dose AraC achieved a complete remission (50%) and 2 a partial remission. No patients in the intermediate dose AraC group achieved a remission (p = 0.05). Toxicity of these protocols was acceptable. Vomiting, headache, somnolence, fever, conjunctivitis, and minor cardiac arrhythmias were found most frequently. The pancytopenic period ranged from 16-30 days for the high dose protocol and 14-23 days for the intermediate dose protocol. Sophisticated isolation and blood banking facilities are required in this period. Median duration of remission was 6 months. Results obtained are in favour of the high dose protocol in refractory leukaemia. Only a large dosage increment of AraC can overcome refractoriness of leukaemic blast cells.
28例连续的难治性急性白血病患者（年龄15 - 58岁，24例急性髓系白血病，4例急性淋巴细胞白血病）接受了高剂量或中剂量阿糖胞苷（AraC）治疗。20例患者接受3000mg/m²的阿糖胞苷，每日2次，共6天（13例单用阿糖胞苷，7例阿糖胞苷联合阿霉素），8例患者接受1000mg/m²的阿糖胞苷，每日2次，共6天并联合柔红霉素。接受高剂量阿糖胞苷治疗的20例患者中有10例获得完全缓解（50%），2例部分缓解。中剂量阿糖胞苷组无患者获得缓解（p = 0.05）。这些方案的毒性是可接受的。最常出现的是呕吐、头痛、嗜睡、发热、结膜炎和轻微心律失常。高剂量方案的全血细胞减少期为16 - 30天，中剂量方案为14 - 23天。在此期间需要完善的隔离和血库设施。缓解期的中位数为6个月。所得结果支持高剂量方案治疗难治性白血病。只有大幅增加阿糖胞苷剂量才能克服白血病原始细胞的难治性。
