Graham M L, Asselin B L, Herndon J E, Casey J R, Chaffee S, Ciocci G H, Daeschner C W, Davis A R, Gold S, Halperin E C, Laughlin M J, Martin P L, Olson J F, Kurtzberg J
Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Bone Marrow Transplant. 1998 May;21(9):879-85. doi: 10.1038/sj.bmt.1701223.
We attempted to administer PEG-L-asparaginase (PEG-L-A) following hematologic recovery to 38 patients undergoing autologous or allogeneic marrow transplantation for acute lymphoblastic leukemia (ALL). Twenty-four patients (12 of 22 receiving allogeneic and 12 of 16 receiving autologous transplants) received between one and 12 doses of PEG-L-A, including nine who completed the planned 12 doses of therapy. The toxicities encountered were similar to those observed in non-transplanted patients undergoing therapy with PEG-L-A and included allergic reactions, pancreatitis, weight loss, hypoalbuminemia, and low levels of anti-thrombin III. Of the 24 who received the drug, eight remain in remission. Of 12 patients in second remission at the time of transplantation who received PEG-L-A, five of seven who received allogeneic and two of five who received autologous transplants remain in remission, 16+ to 46+ months from transplant. While PEG-L-A could be administered to most of the patients undergoing marrow transplantation for ALL, most patients either relapsed while receiving the drug or developed toxicities which resulted in abbreviated courses. At this time, we cannot recommend PEG-L-A as single agent, post-BMT chemotherapy.
我们尝试在38例接受急性淋巴细胞白血病（ALL）自体或异基因骨髓移植的患者血液学恢复后给予聚乙二醇化L-天冬酰胺酶（PEG-L-A）。24例患者（接受异基因移植的22例中的12例以及接受自体移植的16例中的12例）接受了1至12剂PEG-L-A，其中9例完成了计划的12剂治疗。所遇到的毒性与接受PEG-L-A治疗的非移植患者中观察到的毒性相似，包括过敏反应、胰腺炎、体重减轻、低白蛋白血症和抗凝血酶III水平降低。在接受该药物的24例患者中，8例仍处于缓解状态。在移植时处于第二次缓解期且接受PEG-L-A的12例患者中，接受异基因移植的7例中的5例以及接受自体移植的5例中的2例在移植后16 +至46 +个月仍处于缓解状态。虽然PEG-L-A可以给予大多数接受ALL骨髓移植的患者，但大多数患者在接受药物治疗期间复发或出现毒性反应，导致疗程缩短。目前，我们不推荐将PEG-L-A作为BMT后单药化疗药物。
