小剂量阿糖胞苷治疗17例急性非淋巴细胞白血病

Low-dose cytosine arabinoside in treatment of 17 patients with acute nonlymphocytic leukemia

Low dose Ara-C (LDAra-C, Ara-C 10-15 mg/12 h, i.m. x 14-21 days) was used in the treatment of 17 patients with ANLL, and from 14 patients blast cells were isolated before chemotherapy and cultured in the presence of Ara-C (10(-8) and 10(-7) mol/L), no definite induction of differentiation of leukemic cells was found. Of the 17 cases, 5 obtained CR, only one of them with M4 entered CR without pancytopenia or bone marrow aplasia during the LDAra-C treatment. For the rest, 4 with M2 obtained PR, and 8 did not respond. Toxic effects, including pancytopenia and bone marrow aplasia, were observed in most of the patients. Laboratory results showed that differentiation was not induced by Ara-C in low concentration in in vitro culture. LDAra-C is thought to be effective in the treatment of ANLL, and the mechanism may involve both the cytotoxicity and the induction of differentiation of leukemic cells, but the former is far more important.