Grieb P, Stelmasiak Z, Solski J, Nowicki J, Jakubowska B, Ryba M
Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
Arch Immunol Ther Exp (Warsz). 1995;43(5-6):323-7.
We report the results of blood morphology monitoring of 11 remitting-relapsing multiple sclerosis patients who received repeated treatments with cladribine (2-chlorodeoxyadenosine). The drug was given once, daily, subcutaneously (5 mg) or orally (10 mg) for 5 consecutive days, as 6 monthly courses followed by one or two additional courses at 3 or 6 month intervals. The treatments were well tolerated, although many patients suffered from incidental upper respiratory tract infections, most of which occurred during the last 6 months of the observation period. One patient had recurrent infections, including an episode of urosepsis. All infections responded to standard therapy with antibiotics. Progressive lymphocyte reduction to 1000/microliters on average, and clear, but clinically insignificant drop in thrombocytes, was observed. Granulocyte counts were sometimes markedly elevated. A few patients developed macrocytosis, but none required transfusion. With our dosing and schedule, cladribine seems relatively safe in multiple sclerosis patients.
我们报告了11例复发缓解型多发性硬化症患者接受克拉屈滨（2-氯脱氧腺苷）重复治疗的血液形态学监测结果。该药物连续5天每日皮下注射（5毫克）或口服（10毫克）一次，每6个月为一个疗程，之后每隔3或6个月再进行一到两个疗程。治疗耐受性良好，尽管许多患者出现了偶发性上呼吸道感染，其中大多数发生在观察期的最后6个月。一名患者反复感染，包括一次泌尿道脓毒症发作。所有感染对抗生素标准治疗均有反应。观察到淋巴细胞平均逐渐减少至1000/微升，血小板有明显但临床上无显著意义的下降。粒细胞计数有时明显升高。少数患者出现大红细胞症，但无人需要输血。按照我们的给药剂量和疗程安排，克拉屈滨在多发性硬化症患者中似乎相对安全。
