以托泊替康为主治疗难治/复发性急性白血病

目的 评估托泊替康（TPT）为基础的联合方案治疗难治／复发性急性白血病（AL）的疗效和毒性反应。方法 TPT联合阿糖胞苷、安吖啶、环磷酰胺或异环磷酰胺治疗难治／复发性AL17例，均为一个疗程的挽救性化疗。结果 一个疗程化疗后完全缓解（CR）6例（35．3％），部分缓解（PR）4例（23．5％），总有效率58．8％；无效7例（41．2％）。该方案非造血系统毒性反应较轻，仅表现为轻度胃肠道反应及粘膜炎等。但有严重的骨髓抑制，所有的患者均予成份输血支持，14例患者出现不同程度的感染。结论 该方案治疗难治／复发性AL疗效确切，非造血系统毒性反应较轻。

Application of topotecan-based combined chemotherapy for relapsed and refractory acute leukemia

Objective To evaluate the efficacy and toxicity of topotecan-based combined chemotherapy in treating the patients with replased and refractory acute leukemia. Methods Seventeen patients were treated by topotecan with cytarabine, amsacrine, cyclophosamide or ifosfomide. All patients receved a single course as salvage therapy. Results Six patients achieved complete remission with a CR rate of 35. 3%, 4 patients had partial remission with a PR rate of 23. 5%. The total response rate was 58. 8%. Non-hematologic toxicity was mild in the chemotherapy such as mild nausea/vomiting and catarrh. All patients got severe myelogenous cell depression and needed element blood infusion,and 14 patients got different kinds of infection. Conclusion The topotecan-based combined chemotherapy has the significant antileukemic effect and acceptable non-hematologic toxicity in treating patients with relapsed and refractory acute leukemia.