高三尖杉酯碱治疗慢性粒细胞白血病

 　目的　研究高三尖杉酯碱（HHT）治疗慢性粒细胞白血病（CML）的疗效及安全性。方法　12例初诊CML患者，HHT 2.5 mg·m-2·d-1，静脉滴注维持6 h以上，持续14 ~ 21 d为 1个疗程。有效者每月HHT维持治疗，并以外周血中性粒细胞绝对值≥1.0×109／L、血小板≥40×109／L调整用药时间，一般用药5～14 d。每3个月或3个疗程后复查染色体。6个月后以羟基脲（Hu）维持治疗。结果　12例患者中，7例（58.3 %）获血液学完全缓解（CHR），3个疗程后，总的细胞遗传学反应率50 %（3例CCR，3例MCR）；另5例（41.7 %）在治疗3个月内进入加速期或急变期（4例发生在HHT 1个疗程后）。12例患者中有6例出现严重骨髓抑制，均发生于CHR者。结论　HHT治疗CML-CP，可获得较高的血液学和细胞遗传学缓解率，但也可能早期进入加速期或急变期。

Clinical analysis on chronic myelogenous leukemia patients treated with homoharrintonine

Objective　To investigate the antileukemic efficacy and toxicity of homoharringtonine(HHT) therapy in chronic myelogenous leukemia(CML). Methods　Twelve patients with Philadelphia chromo－some positive(Ph+) CML in chronic phase were treated with a continuous 6 hours infusion of HHT at a daily dose of 2.5 mg/m2 for 14-21 days. Patients who got hematological remission received maintain therapy for 5-14 days every month. The number of days could be adjusted according to the absolute granulocyte count and platelet(ANC>≥ 1.0×109/L; PLT≥40×109/L). Every 3 cycles or 3 months of HHT treatment, the change of Ph chromosome was determined . After 6 months, the patients were maintained with hydroxyurea. Results　Of the 12 patients, 7(58.3%) achieved complete hematological remission(CHR). Among the 6 patients (50 % of the total patients) who got a cytogenetic response after 3 cycles, 3 had completely cytogenetic remission and others have minimal response. Another 5 patients(41.7 %) evolved to accelerated or blastic phase earlier in 3 months(4 patients after 1 course of HHT). Conclusion　Although CML-CP patients treated with HHT may have high hematological and cytogenetic response, there were a risk of evolving to accelerated or blastic phase earlier.