Rivera G, Aur R J, Dahl G V, Pratt C B, Wood A, Avery T L
Cancer. 1980 Mar 15;45(6):1284-8. doi: 10.1002/1097-0142(19800315)45:6<1284::aid-cncr2820450604>3.0.co;2-q.
On the basis of previous findings at this institution, VM-26 and Cytosine Arabinoside (ara-C) were used in combination to treat 33 children with refractory acute lymphocytic leukemia (ALL). Chemotherapy was given by vein twice a week for four weeks at dosage of 300 mg/m2 for ara-C and 50, 75, 110, 165, or 200 mg/m2 for VM-26. Ten marrow remissions (nine complete and one partial) were induced, with hypotension (2/33) and bone marrow hypoplasia (20/33) the most significant side effects observed. Therapeutic responses were obtained with each dosage of VM-26 except 75 mg/m2; myelosuppression developed at all dosages, being most prolonged at 200 mg/m2. Ten of the 23 non-responders did not complete their planned courses of therapy. The significance of this information is that combinations of VM-26 and ara-C were effective in patients who were either in late stages of their leukemia or had never achieved an initial remission. All had been previously treated with prednisone, vincristine, daunomycin and L-asparaginase. In addition, seven of the 10 responders had previously received ara-C in other drug combinations. The use of VM-26 and ara-C in combination may be warranted for newly diagnosed patients who are at high risk for treatment failure with first-line drugs.
根据该机构之前的研究结果，使用威猛（VM - 26）和阿糖胞苷（ara - C）联合治疗33例难治性急性淋巴细胞白血病（ALL）患儿。化疗通过静脉给药，每周两次，共四周，阿糖胞苷剂量为300 mg/m²，VM - 26剂量为50、75、110、165或200 mg/m²。诱导出10例骨髓缓解（9例完全缓解和1例部分缓解），观察到的最显著副作用为低血压（2/33）和骨髓发育不全（20/33）。除75 mg/m²剂量的VM - 26外，其他各剂量均获得了治疗反应；所有剂量均出现骨髓抑制，200 mg/m²剂量时骨髓抑制持续时间最长。23例无反应者中有10例未完成计划的疗程。该信息的意义在于，VM - 26和ara - C联合用药对处于白血病晚期或从未获得初始缓解的患者有效。所有患者此前均接受过泼尼松、长春新碱、柔红霉素和L - 天冬酰胺酶治疗。此外，10例有反应者中有7例此前在其他联合用药方案中接受过阿糖胞苷治疗。对于一线药物治疗失败风险高的新诊断患者，可能有必要使用VM - 26和ara - C联合治疗。
