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大部分白血病患者对抗白血病药物治疗能取得疗效,部分患者即使体内长期残留有白血病细胞,也可以终身不复发,可认为已治愈,但获得缓解后白血病患者常见的结局仍然是复发。化疗对于复发者疗效通常较差。此种情况可称耐药。产生耐药的原因还不清楚,有两种推测:(1)是治疗诱发白血病细胞耐药。这种情况仅发生于以前用过的药物,与以前所用药物相关的或甚至不同的药物。可能由于多种耐药基因表达或放大。(2)是治疗前就存在着耐药的白血病细胞。当白血病细胞群中这种耐药细胞很少时,化疗有效;如果耐药细胞占优势,则化疗无效。由于对两类耐药白血病的化疗方法选择不同,所以互相区别很重要。如果是化疗导致的耐药,就应当快速改换多种药物的联合治疗以减少耐药细胞的
The majority of leukemia patients can obtain curative effect against leukemia drug treatment. Some patients may still have no recurrence for a long period of time even if they have leukemia cells in their body, which may be considered to have been cured. However, the common outcome of leukemia patients after remission is still recurrence. Chemotherapy is usually poorer for relapsers. This situation can be called drug resistance. The reason for the emergence of drug resistance is still unclear. There are two kinds of hypotheses: (1) Treatment induces drug resistance in leukemia cells. This situation only occurs with previously used drugs, drugs associated with previously used drugs or even different drugs. It may be due to the expression or amplification of multiple drug resistance genes. (2) There is a drug-resistant leukemic cell before treatment. Chemotherapy is effective when the number of such resistant cells in a leukemia cell population is small, and chemotherapy is ineffective if the resistant cells are dominant. Because of the different choices of chemotherapy for the two types of drug-resistant leukemia, it is important to distinguish them from each other. If it is chemotherapy-induced resistance, it should quickly change the combination of multiple drugs to reduce the number of drug-resistant cells.