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目的对中、大剂量阿糖胞苷(ID/HDAra蛳C)为主的化疗方案治疗急性非淋巴细胞白血病缓解期的疗效进行研究。方法化疗前用MTT法测定骨髓病变细胞对不同浓度Ara蛳C的药物敏感性,化疗时测定其血药浓度及脑脊液中药物浓度,观察疗效及毒副作用。结果93.3%患者骨髓病变细胞对高浓度Ara蛳C敏感,其中28.6%对中浓度Ara蛳C敏感,所有患者对低浓度Ara蛳C不敏感。血浆中Ara蛳C浓度随滴注时间逐步上升,滴注结束后迅速下降,药物可顺利通过血脑脊液屏障,该治疗毒副反应轻。结论ID/HDAra蛳C治疗既可强烈清除缓解后体内残留的肿瘤细胞,又能有效预防中枢神经系统白血病,且毒副作用小,在体内代谢快,无药物累积。
Objective To study the curative effect of medium and large dose of cytarabine (ID / HDAra 蛳 C) chemotherapy regimen in the treatment of acute non-lymphocytic leukemia in remission period. Methods Before chemotherapy, MTT assay was used to determine the drug susceptibility of bone marrow cells to different concentrations of Ara 蛳 C. The plasma concentration of CSF and drug concentration in CSF were measured during chemotherapy. The curative effect and toxicity were observed. Results 93.3% of patients with bone marrow lesions were sensitive to high concentration Ara 蛳 C, 28.6% of them were sensitive to moderate concentration of Ara 蛳 C and all patients were not sensitive to low concentration of Ara 蛳 C. The concentration of Ara 蛳 C in plasma gradually increased with the time of instillation, dropping rapidly after the end of instillation, and the drug could pass the blood-cerebrospinal fluid barrier smoothly. The toxicity of the treatment was mild. Conclusion ID / HDAra 蛳 C treatment can not only eliminate the residual tumor cells in vivo but also effectively prevent central nervous system leukemia with less side effects and faster metabolism in the body without drug accumulation.