Doll D C, Kasper L M, Taetle R, List A F
Department of Medicine, Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia 65212, USA.
Leuk Res. 1998 Jan;22(1):7-12. doi: 10.1016/s0145-2126(97)00149-5.
Forty-three patients with myelodysplastic syndromes (MDS) received treatment with oral etoposide 50 mg/day for 21 consecutive days every 4 weeks. Eighteen patients (42%) experienced hematological responses, including 12 of 17 (70%) patients with chronic myelomonocytic leukemia (CMML). Three of five CMML patients who failed treatment with hydroxyurea experienced major hematological responses with oral etoposide. Median response duration exceeded 9 months (range: 4-49 + months), and one patient remains in an unmaintained complete remission for 4 years. Toxicity included nausea/vomiting in five patients, fever (four patients), infection (three patients), mucositis (two patients), and anorexia (two patients). Two patients had grade 4 neutropenia with sepsis necessitating treatment withdrawal. We conclude that low-dose oral etoposide has remitting activity in MDS and is an effective treatment alternative for patients with CMML.
43例骨髓增生异常综合征（MDS）患者接受口服依托泊苷治疗，剂量为50mg/天，每4周连续用药21天。18例患者（42%）出现血液学反应，其中17例慢性粒单核细胞白血病（CMML）患者中有12例（70%）出现反应。5例接受羟基脲治疗失败的CMML患者中有3例口服依托泊苷后出现主要血液学反应。中位反应持续时间超过9个月（范围：4 - 49 +个月），1例患者持续未维持完全缓解达4年。毒性反应包括5例患者出现恶心/呕吐、4例发热、3例感染、2例黏膜炎和2例厌食。2例患者出现4级中性粒细胞减少伴败血症，需要停药。我们得出结论，低剂量口服依托泊苷对MDS有缓解活性，是CMML患者的一种有效治疗选择。
