培门冬酶与左旋门冬酰胺酶治疗儿童白血病效果比较

目的观察比较培门冬酶（PEG-ASP）与左旋门冬酰胺酶（L-ASP）治疗儿童急性淋巴细胞白血病（ALL）的临床效果及酶活性变化。方法回顾性分析54例初发的ALL病儿,在诱导缓解期中采用L-ASP治疗27例,PEG-ASP治疗27例,观察两组病儿骨髓抑制程度、恢复时间及临床缓解程度,比较两组病儿微小残留病（MRD）值及门冬酰胺酶的活性。结果两组病儿骨髓抑制恢复时间比较差异有显著性（t=3.05,P〈0.05）;低、中、高危组病儿骨髓抑制程度比较差异均无显著性（P〉0.05）;L-ASP组低、中、高危及T系、B系ALL的临床缓解程度与PEG-ASP组相比,差异均无显著性（P〉0.05）;L-ASP、PEG-ASP诱导治疗后,两组MRD值比较差异均无显著性（P〉0.05）;L-ASP及PEG-ASP用药后活性均大于100U.L-1,且PEG-ASP活性持续2周。结论 L-ASP与PEG-ASP治疗儿童ALL疗效相当,但PEG-ASP的作用时间长,值得临床进一步推广应用。

COMPARISON OF EFFICACY BETWEEN L-ASPARAGINASE AND PEGASPARGASE IN THE TREATMENT OF CHILDREN WITH LEUKEMIA

Objective To evaluate the clinical effect and enzymatic activity of L-asparaginase （L-ASP） and pegaspargase （PEG-ASP） in the treatment of children with acute lymphoblastic leukemia （ALL）. Methods A retrospective analysis was done in 54 kids with incipient ALL, who were equally randomized to L-ASP or PEG-ASP therapy during remission induction （RI） phase. The degree of bone marrow depression （BMD）, duration of recovery, clinical remission, minimal residual disease and as paragianse activity were observed and compared between the two groups. Results The difference of time of recovery of BMD was significant between the sick children treated in L-ASP and PEG-ASP groups （t= 3.05, P〈0.05）, but the difference of the ex tent of BMD among the low risk, moderate-risk and high-risk groups was not statistically significant （P〉0.05） A comparison be tween L-ASP and PEG-ASP groups, the clinical relief of high-, moderate and low-risk patients was not significantly different （P〉 0.05）. After inductive treatment of L-ASP and PEG-ASP, the difference of MRD value between the two groups was not significant （P〉0.05）, the serum enzymatic activity in both groups was higher than 100 U· L-1 , lasting for two weeks in PEG-ASP group. Conclusion The efficacy of PEG-ASP and L-ASP in the treatment of ALL is similar, but the action time of PEG-ASP is longer, which is worthy of further clinical application.