大剂量MTX治疗儿童ALL副作用防治研究

目的研究大剂量甲氨蝶呤(methotrexate，MTX)对急性淋巴细胞性白血病患儿的中枢神经系统白血病的预防，观察其毒副作用。方法13例ALL患儿接受57例次HD-MTX(每次3．0g／m^2)治疗。经综合预防措施后，观察临床症状、体征和实验室指标，总结HD-MTX的副作用发生种类、发生率及临床疗效。结果13例ALL中11例未发生CSNL，2例治疗中出现CNSL，经治疗后CR，现仍处于CCR中。13例平均CCR 31．8个月。结论儿童对HDMTX耐受性好，HD-MTX可以有效预防ALL的CNSL复发，提高长期无病生存率。

Study on MTX Treatment in Preventing Childhood ALL from CNSL and Its Side Effects

Objective To investigate the effects of high-dose methotrexate (MTX) on central nervous system leukemia (CNSL) prophylaxis in childhood ALL and to observe the toxic side effects.Methods 13 children with ALL received 57 times MTX treatment (3.0 g/m2,every time).The comprehensive measures for preventing complications were taken after chemotherapy.The clinical symptoms and the main toxic side effects were observed.Results There were no severe toxic side effects in these cases.2 cases had occurred CNSL.Now all these cases had got continuous complete remissions.Conclusion Children are rather tolerable to MTX therapy and it is effective in preventing CNSL and in increasing the long-term disease free survival period.