培门冬酶治疗儿童急性淋巴细胞白血病临床观察

目的探讨培门冬酶在儿童急性淋巴细胞白血病(ALL)中应用的疗效及安全性。方法 62例初发ALL患儿,均按ALL-XH-99方案进行治疗。对照组34例采用VDLP方案(长春新碱+柔红霉素+左旋门冬酰胺酶+泼尼松)进行诱导缓解治疗和巩固强化治疗;试验组28例将前方案中左旋门冬酰胺酶改为培门冬酶,余不变。比较2组临床疗效和安全性。结果试验组的完全缓解率为93%,对照组为91%,无显著差异(P>0.05)。试验组2年无进展生存率为75%,总生存率为89%;对照组2年无进展生存率为71%,总生存率为85%,差异均无显著意义(P>0.05)。试验组肝功能损害发生率(17%)低于对照组(56%),差异有显著意义(P<0.05),且试验组未出现严重过敏反应发生。结论培门冬酶在治疗儿童ALL中具有与左旋门冬酰胺酶相当的疗效和较低的不良反应。

Applications of pegaspargase in childhood acute lymphoblastic leukemia.

Objective To observe the efficacy and safety of pegaspargase application in childhood with acute lymphoblastic leukemia（ALL）.Methods Sixty-two children with initial ALL were all treated with the Shanghai Children＇s Medical Center ALL-XH-99 program.Thirty-four children in the control group were treated with vincristine＋daunorubicin＋L-asparaginase＋prednisone（VDLP） remission induction and consolidation of intensive treatment.The L-asparaginase was replaced by pegaspargase in the trial group for 28 cases of children.The clinical efficacy and adverse reactions were observed.Results The complete remission rate of the trial group was 93%,and 91% of the control group,showed no significant difference（P0.05）.Two-year progression-free survival rate in the trial group was 75% and the overall survival rate was 89% in the control group.The corresponding rate was 71% and 85% in the control group,showed no significant difference（P 0.05）.The rate of liver dysfunction in the trial group（17%） was lower than that in the control group（56%,P0.05）.There was no severe allergic reactions occurred in the trial group.Conclusion Pegaspargase has the equivalent efficacy and less adverse reactions in the treatment of childhood ALL compared with L-asparaginase.