大剂量甲强龙联合方案治疗复发或高危儿童急性淋巴细胞白血病的临床研究

 目的 评估大剂量甲强龙（HDMP）为主的联合化疗方案对复发或高危儿童急性淋巴细胞白血病（ALL）的疗效和毒副作用。方法 选择2003年6月至2006年2月收治的复发和高危ALL患儿19例，年龄3～16岁，中位年龄7岁；其中男14例，女5例，16例为复发和多次复发，3例为初诊高危组且泼尼松预治疗反应不佳，全部接受大剂量甲强龙联合方案治疗。结果 19例HDMP方案再诱导治疗者，CR 17例，CR率94 %，NR1例，早期死亡1例。患者不良反应主要有感染、血压增高、肌无力、消化道反应和凝血功能异常。结论 HDMP为主的联合化疗方案对复发或高危儿童ALL的疗效显著，在加强支持对症治疗下不良反应可以控制。

The clinical study of HDMP combined chemotherapy on relapsed or in high risk children with acute lymphoblastic leukemia

Objective To evaluate the effect and toxic effect of HDMP in combined chemotherapy on replased or high risk children with acute lymphoblastic leukemia. Methods 19 patients (14 boys ,5 girls) who relapsed or in high risk were enrolled in our department from June 2003 to February 2006. The patients ranged in age from 3 to 16 years(mean,7years). Among them, 16 cases were replased or repeated replased, 3 cases were preliminary diagnosised in high risk and negative to the prednisone pretreatmeat. All patients ac－cepted the high-dose methylprednisolone (HDMP) combined chemotherapy. Results 17 cases obtained CR in 19 patients who accepted the HDMP reinduced therapy, the CR rate is 95 %. 1 case got NR, and 1 case died in the early time. The main toxic effects are infection, high blood pressure, amyasthenia. Conclusion Chemotherapy combined dominanting HDMP treatment is remarkablely effect on the relapsed or high risk children acute lymphoblastic leukemia. The toxic effects can be controled under the intensive supportive and symptomatic treatment.