Moreno S, Miralles P, Díaz M D, Berenguer J, Bernaldo de Quirós J C, Blázquez R, Cosín J, Bouza E
Department of Clinical Microbiology, Hospital General Universitario, Gregorio Marañón, Madrid, Spain.
Clin Infect Dis. 1996 Nov;23(5):1066-8. doi: 10.1093/clinids/23.5.1066.
To evaluate the efficacy and safety of intravenous cytarabine in the treatment of AIDS-associated progressive multifocal leukoencephalopathy (PML), we reviewed the charts of all human immunodeficiency virus-infected patients with PML who were seen during a 28-month period at our institution. Patients with biopsy-proven PML were offered therapy with intravenous cytarabine (2 mg/[kg.d] for 5 days every 4 weeks). The diagnosis of PML was histologically confirmed for 13 patients. The median CD4 cell count was 91 x 10(6)/L. A median of three courses of cytarabine was administered to eight patients. Two patients developed mild drug-related toxicities. Clinical and/or radiological signs of improvement were observed for three patients treated with cytarabine; no signs of improvement were noted for the untreated patients. Median survival time after the diagnosis of PML was 102 days (range, 46-220 days) for patients who received cytarabine and 60 days (range, 28-72 days) for untreated patients matched for Karnofsky scores (P = .06, logrank test). Although cytarabine is well tolerated by patients with AIDS and PML, only modest short-term clinical improvement in the conditions of patients treated with the drug has been observed, with no significant impact on survival.
为评估静脉注射阿糖胞苷治疗艾滋病相关进行性多灶性白质脑病（PML）的疗效和安全性，我们回顾了在我院28个月期间就诊的所有感染人类免疫缺陷病毒且患有PML的患者病历。经活检证实为PML的患者接受静脉注射阿糖胞苷治疗（每4周2 mg/[kg·d]，共5天）。13例患者的PML诊断经组织学证实。CD4细胞计数中位数为91×10⁶/L。8例患者接受了中位数为三个疗程的阿糖胞苷治疗。2例患者出现轻度药物相关毒性。接受阿糖胞苷治疗的3例患者观察到临床和/或影像学改善迹象；未治疗患者未观察到改善迹象。接受阿糖胞苷治疗的PML患者诊断后的中位生存时间为102天（范围46 - 220天），与卡诺夫斯基评分匹配的未治疗患者为60天（范围28 - 72天）（P = 0.06，对数秩检验）。尽管艾滋病合并PML患者对阿糖胞苷耐受性良好，但仅观察到接受该药物治疗的患者病情有适度的短期临床改善，对生存无显著影响。
