小儿骨髓异常增生综合征的治疗

我们对12例骨髓异常增生综合征（MDS）患儿进行了分型治疗。9型RAEB型以小剂量Ara－c治疗为主，10－30mg／d，肌注或静滴，1个月为1疗程。3例RAEB－T型根据病态增生的细胞不同采取不同的化学治疗，如VDP方案或DOAP方案。症状改善、血象好转及骨髓完全缓解后再予小剂量Ara－c。维持治疗2～3年。在分型治疗的同时采取综合治疗措施，积极防治感染，并防治重要脏器出血，适当应用血液成分，加强营养，防治用药副作用，12例患儿经治疗后，2例基本缓解，5例进步，5例无效，总有效率达60％，高于一般报道，且在治疗期间未发生严重感染，一般感染能迅速被控制，多数病儿的出血症状能被及时改善，治疗的副作用很少。结果表明：对患儿实行分型治疗、综合治疗及长期治疗有较好的效果。

TREATMENT ON CHILDREN WITH MYELODYSPLASTIC SYNDROMS

In recent years, we have treated 12 children with myelodysplastic syndromes according to their types and we have given them comprehensive therapy and long term treatment. 9cases of RAEB were given low dose of Ara--c, 10mg/day. 3 cases of RAEB--T were givenchemotherapy:VDP or CODP (according to the abnormal Increased cells )' When symptomsimproved, blood picture got better, bone marrow showdes complete remission, with low dose of Ara Ale or 6--MP and MTX were administrated for maintenance therapy for 2 -- 3 years.At the same time, we gave the comprehensive therapy:aspreventing and curing the infectious diseases, preventing the important organs bleeding, transfusing the blood components,strenthening the nutrition and preventing and curing the side effect. The results showed that 2 of 12 cases achieved basic remission and 5 cases improved and 5 of 12 cases made progress.The response rate was 60%. There were no serious infectious diseases during the treatment.The mild bleeding and Infectious diseases could be controled very well. There was almost littie side effect. In conclusion, treating the childhood MDS according to its type and giving comprehensive therapy can improve the efficacy.