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[急性髓性白血病患者对强化联合化疗难以耐受时,采用小剂量阿糖胞苷和依托泊苷持续输注治疗]

[Continuous infusion therapy with low dose cytosine arabinoside and etoposide in acute myelogenous leukemia patients hardly tolerable for intensive combination chemotherapy].

作者信息

Tsurumi H, Miura T, Yamada T, Sawada M, Nakamura N, Tomoda T, Takahashi T, Oyama M, Moriwaki H, Muto Y

机构信息

First Department of Internal Medicine, Gifu University School of Medicine.

出版信息

Rinsho Ketsueki. 1995 Jul;36(7):657-64.

PMID:7563593
Abstract

We evaluated the efficacy of continuous drip infusion therapy with low dose cytosine arabinoside (AraC) and etoposide (VP16) in poor-condition patients with acute myelogenous leukemia (AML). Patients' age ranged from 19 to 85 years with a median of 63 years. Principally they received continuous drip infusion for 14 days with AraC (20 mg/day) and VP16 (50 mg/day). Complete remission (CR) rate was 58.3% (7/12) in untreated cases, 33.3% (2/6) in refractory cases to the standard chemotherapy, and 28.6% (2/7) in relapsed cases. The duration of CR ranged from 1.5 to 20 (+) months (median 8) in untreated group and from 2 to 22 months (median 10) in refractory and relapsed groups. Adverse effects such as gastroenterological symptoms appeared but were tolerable. Although infections due to myelosuppression appeared in 22 of 25 cases, they were well controlled by antibiotics. Chemotherapy-related death was not observed. Although CR rate and CR duration of this therapy were not sufficiently high, the regimen was effective in some patients with refractory or relapsed AML. Further studies are required to establish the efficacy, indication and safety of this treatment.

摘要

我们评估了小剂量阿糖胞苷(AraC)和依托泊苷(VP16)持续滴注疗法对病情较差的急性髓系白血病(AML)患者的疗效。患者年龄在19至85岁之间,中位年龄为63岁。主要给予患者阿糖胞苷(20毫克/天)和依托泊苷(50毫克/天)持续滴注14天。未治疗病例的完全缓解(CR)率为58.3%(7/12),对标准化疗耐药病例的CR率为33.3%(2/6),复发病例的CR率为28.6%(2/7)。未治疗组的CR持续时间为1.5至20(+)个月(中位时间8个月),耐药和复发组为2至22个月(中位时间10个月)。出现了诸如胃肠道症状等不良反应,但可以耐受。虽然25例中有22例出现了骨髓抑制导致的感染,但通过抗生素得到了很好的控制。未观察到化疗相关死亡。虽然该疗法的CR率和CR持续时间不够高,但该方案对一些难治性或复发性AML患者有效。需要进一步研究以确定该治疗方法的疗效、适应证和安全性。

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