沙格司亭治疗白细胞减少症34例

目的观察沙格司亭治疗白细胞减少症的临床效果,探讨优化治疗白细胞减少症的有效方法。方法将34例白细胞减少症患者平均分为治疗组和对照组,对照组患者服用普通提升白细胞的药物,治疗组患者使用集落刺集因子类药物沙格司亭,每隔一段时间对全部患者进行血常规检查,测定白细胞数目,比较分析两组的临床疗效。结果治疗组治疗后5 d,10 d,15 d的白细胞数量分别为(3.83±0.76)×109/L,(4.21±0.49)×109/L(,4.54±1.10)×109/L,与对照组比较有统计学意义(P<0.05)。结论沙格司亭疗效明显,可作为治疗白细胞减少症的有效药物在临床推广使用。     

补肾养血法治疗狼疮肾炎环磷酰胺冲击疗法后引起的白细胞减少症临床研究

目的：观察补肾养血法治疗狼疮肾炎环磷酰胺冲击疗法后引起的白细胞减少症的临床疗效。方法：将30例患者随机分为治疗组16例与对照组14例,治疗组给予补肾养血中药治疗,对照组口服利可君、维生素B4片、肌苷片,两组均以14 d为1疗程。结果：治疗组有效率93.7%,对照组有效率71.0%,治疗组疗效明显优于对照组（P〈0.01）。结论：补肾养血中药治疗狼疮肾炎环磷酰胺冲击疗法后引起的白细胞减少症有较好的临床疗效。     

Carboplatin-paclitaxel-induced leukopenia and neuropathy predict progression-free survival in recurrent ovarian cancer

Background:

We assess the prognostic value of chemotherapy-induced leukopenia and sensory neuropathy in the CALYPSO trial patients treated with carboplatin–paclitaxel (CP) or carboplatin–liposomal doxorubicin (CPLD).

Methods:

We performed a landmark analysis at first month after randomisation to correlate leukopenia (nadir white blood cell <4.0 × 10⁹ per litre or severe infection) during cycle 1 of chemotherapy with progression-free survival (PFS). Using time-dependent proportional-hazards models, we also investigated the association between neuropathy and PFS.

Results:

Of 608 patients with nadir blood and did not receive growth factors, 72% (CP=70%, CPLD=73%) had leukopenia. Leukopenia was prognostic for PFS in those receiving CP (adjusted hazard ratio (aHR) 0.66, P=0.01). Carboplatin–liposomal doxorubicin was more effective than CP in patients without leukopenia (aHR 0.51, P=0.001), but not those experiencing leukopenia (aHR 0.93, P=0.54; interaction P=0.008).Of 949 patients, 32% (CP=62%, CPLD=28%) reported neuropathy during landmark. Neuropathy was prognostic for PFS in the CP group only (aHR 0.77, P=0.02). Carboplatin–liposomal doxorubicin appeared to be more effective than CP among patients without neuropathy (aHR 0.70, P<0.0001), but not those with neuropathy (aHR 0.96, P=0.81; interaction P=0.15).

Conclusion:

First-cycle leukopenia and neuropathy were prognostic for patients treated with CP. Efficacy of CP treatment was similar to CPLD in patients who developed leukopenia. These findings support further research to understand the mechanisms of treatment-related toxicity.     

Graves病伴白细胞减少症27例131碘治疗体会

[目的]总结131碘(I)在Graves病伴白细胞减少症治疗中的体会。[方法]对2002年5月~2004年8月经131I治疗的Graves病伴白细胞减少症27例患者的临床资料进行回顾性分析。[结果]采用131碘治疗的Graves病患者全部治愈,其中2例出现早发甲减,白细胞计数未见降低。[结论]对本病的治疗,131I是较理想的方法。     

EDTA‐induced pseudo‐neutropenia resolved with kanamycin

This report describes a case of spurious neutropenia caused by EDTA‐dependent in vitro agglutination of neutrophils. After raising the temperature of the sample to 37°C the agglutination was irreversible, but it resolved completely after addition of kanamycin. Previously this method has been shown to be effective in EDTA‐dependent pseudo‐thrombocytopenia, but this is the first report demonstrating successful application in EDTA‐dependent pseudo‐neutropenia.     

Granulocytopenia associated with neuroleptic therapy in a patient with benign familial leukopenia

Benign familial leukopenia (BFL) has been reported in several ethnic groups, including Ethiopians of Jewish origin. To date, there are no reported cases of patients with BFL developing granulocytopenia following administration of neuroleptics. We report a case of a young Ethiopian Jew suffering from schizophrenia, who exhibited premorbid benign reduced white blood cells (WBC) count and developed leukopenia and neutropenia following exposure to typical (zuclopentixol, perphenazine, haloperidol) antipsychotics and the atypical antipsychotic risperidone. The diagnosis of BFL was established and tissue typing of the patient was determined. To the best of our knowledge, this is the first report of leukopenia with neutropenia in an ethnically susceptible (due to BFL) schizophrenia patient following exposure to typical and atypical antipsychotics. HLA typing of this patient was distinct from that reported in patients susceptible to clozapine-induced agranulocytosis. Further extensive investigations including HLA typing in a larger cohort of schizophrenic patients is needed in order to define the association between HLA haplotypes and neuroleptic-induced hematological reactions and to identify the potentially vulnerable individuals.     

中医辨证施治治疗放化疗白细胞减少症的临床研究

目的 观察中医辨证施治治疗肿瘤放化疗白细胞减少症疗效.方法 将81例恶性肿瘤放化疗后白细胞减少症患者随机分成2组,分别以中医药辨证论治（辨证分型方药＋对症用药）和西药（利血生＋鲨肝醇）进行治疗,口服用药,连续30d,每周检测外周血白细胞总数1次,并观察相应临床症状的改善状况.结果 中医辨证施治组有39例痊愈,有效2例,总有效率为100%;而西药对照组痊愈16例,有效15例,无效10例,总有效率为75.6%.二者效果差异显著（P＜0.05）.结论 中医辨证施治治疗放化疗后白细胞减少症能针对肿瘤患者复杂病情和临床表现的差异,从而达到最佳治疗效果.