大剂量甲氨蝶呤及左旋门冬酰胺酶治疗成年人高危费城染色体阴性急性淋巴细胞白血病

目的 探讨大剂量甲氨蝶呤(MTX)及左旋门冬酰胺酶(L-Asp)治疗成年人高危费城染色体阴性(Ph-)急性淋巴细胞白血病(ALL)的疗效及安全性.方法 5例成年高危Ph-ALL患者均接受多疗程MTX(3～5g/m2,持续静脉滴注24 h)以及L-Asp(8 000 ～ 10 000 U/次,1次/d,共10次)交替巩固强化治疗.结果 5例患者均无病生存,生存时间60～96个月,中位生存时间73个月.骨髓抑制轻微,无明显肝肾损害、严重变态反应及胰腺炎等严重不良反应.结论 大剂量MTX及L-Asp对成年高危Ph-ALL患者疗效肯定,耐受性好,对于患者长期生存有重要意义.

High-dose methotrexate and L-asparaginase for the treatment of adult patients with high risk Ph-acute lymphoblastic leukemia

Objective To explore the efficacy and safety of high-dose methotrexate (MTX) and L-asparaginase (L-Asp) for the treatment of adult patients with high risk Ph acute lymphoblastic leukemia (ALL).Methods Five adult patients with high risk Ph-ALL were treated with several courses of MTX (3-5 g/m2 by continually intravenous drip for 24 h) and L-Asp (8 000-10 000 U/time, once a day, 10 times for one cycle).Results Five patients were disease-free survival, their survival time was 60-96 months and the median survival time was 73 months.The chemotherapy-related bone marrow depression was mild.No obvious liver and kidney damage, severe allergic reaction and pancreatitis were observed.Conclusion Highdose MTX and L-Asp are effective and well tolerated, and may contribute to long-term survival of adult patients with high risk Ph-ALL.