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[伊达比星成功治疗1例复发时伴有额外染色体异常的t(8;21)急性髓性白血病儿科病例]

[Successful treatment with idarubicin in a pediatric case of t(8;21) acute myelogenous leukemia with additional chromosomal abnormalities at relapse].

作者信息

Wakazono Y, Kataoka A, Fusaoka T, Tunamoto K

机构信息

Department of Pediatrics, Kyoto-Katsura Hospital.

出版信息

Rinsho Ketsueki. 1998 Jul;39(7):499-505.

PMID:9750457
Abstract

A 9-year old boy was admitted to our hospital due to a relapse of acute myelogenous leukemia (AML). A chromosomal analysis at the time of relapse revealed abnormalities in addition to 45, X,-Y, t(8;21) (q22;q22) when AML was first diagnosed. The patient was given granulocyte-colony stimulating factor (G-CSF), cytosine arabinoside (Ara-C) and aclarubicin (CAG therapy), but this treatment regimen was not effective. He was next treated with G-CSF (started 3 days prior to the administration of anticancer drugs), Ara-C, (200 mg/mm2 for 7 days), Etoposide (VP.16, 150 mg/mm2 for 5 days) and Idarubicin (8 mg/mm2 for 5 days) according to the modified Japan Cooperative Protocol ANLL 91 for children. Although his condition had been septic and he had experienced renal and respiratory failure, he achieved a complete remission after 140 days without additional therapy. The patient returned to a condition of health and received a bone marrow transplant from an unrelated donor. We concluded that this treatment regimen is effective for the relapse of AML in children.

摘要

一名9岁男孩因急性髓性白血病(AML)复发入院。复发时的染色体分析显示,除了首次诊断AML时的45,X,-Y,t(8;21)(q22;q22)外,还存在其他异常。给予患者粒细胞集落刺激因子(G-CSF)、阿糖胞苷(Ara-C)和阿柔比星(CAG方案),但该治疗方案无效。接下来,根据修改后的日本儿童急性非淋巴细胞白血病(ANLL)91合作方案,给予患者G-CSF(在给予抗癌药物前3天开始)、Ara-C(200mg/mm²,持续7天)、依托泊苷(VP-16,150mg/mm²,持续5天)和伊达比星(8mg/mm²,持续5天)。尽管患者曾发生败血症,并有肾和呼吸功能衰竭,但未经额外治疗,140天后实现完全缓解。患者恢复健康,并接受了来自无关供体的骨髓移植。我们得出结论,该治疗方案对儿童AML复发有效。

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