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目的应用超大剂量阿糖胞苷(SHDAra-C)对急性髓细胞白血病(AML)患儿进行缓解后治疗,探讨其疗效及安全性。方法在患者取得骨髓缓解后应用SHDAra-C共五个疗程,第一疗程Ara-C总剂量达36 g/m2,其后每疗程Ara-C总剂量18 g/m2,累计Ara-C总剂量达108 g/m2。结果8例AML患儿有7例完成了5个疗程HDAra-C化疗(1例只完成4疗程),除1例骨髓复发放弃治疗外,余7例均获CCR至今,CCR时间6~76月,无一例化疗相关性死亡。结论SHDAra-C是小儿AML化疗获得长期无病生存的重要治疗方法,有效且相对安全,其治疗效果值得更大规模的临床病例观察,治疗机理有待更深入的实验研究。
Objective To investigate the efficacy and safety of super large dose of cytarabine (SHDAra-C) in children with acute myeloid leukemia (AML) after remission. Methods The total dose of Ara-C was 36 g / m2 in the first course of treatment and the total dose of Ara-C was 18 g / m2 in the first course of treatment. The total Ara-C dose Up to 108 g / m2. Results Of the 8 children with AML, 7 completed 5 courses of HDAra-C chemotherapy (1 completed only 4 courses), except one case of bone marrow recurrence and abandonment, the remaining 7 cases received CCR till now and the CCR time was 6 to 76 months , No case of chemotherapy-related deaths. Conclusion SHDAra-C is an important treatment for long-term disease-free survival in pediatric AML chemotherapy. It is effective and relatively safe. The therapeutic effect of SHDAra-C is worth to be observed in a larger scale. The treatment mechanism needs further experimental study.