超大剂量阿糖胞苷在小儿急性髓细胞白血病的治疗探讨

目的应用超大剂量阿糖胞苷(SHDAra-C)对急性髓细胞白血病(AML)患儿进行缓解后治疗,探讨其疗效及安全性。方法在患者取得骨髓缓解后应用SHDAra-C共五个疗程,第一疗程Ara-C总剂量达36 g/m2,其后每疗程Ara-C总剂量18 g/m2,累计Ara-C总剂量达108 g/m2。结果8例AML患儿有7例完成了5个疗程HDAra-C化疗(1例只完成4疗程),除1例骨髓复发放弃治疗外,余7例均获CCR至今,CCR时间6~76月,无一例化疗相关性死亡。结论SHDAra-C是小儿AML化疗获得长期无病生存的重要治疗方法,有效且相对安全,其治疗效果值得更大规模的临床病例观察,治疗机理有待更深入的实验研究。

Study on SHDAra-C for postrenission treatmemt of children with AML

Objective To observe the safety and efficacy of super high dose cytoarabine(SHDAra-C) as postremission therapeutic regimen in children with AML. Methods Eight patients were treated with SHDAraeC when complete remission was obtained.SHD Ara-C regimen was consisted of 5 cycles,including 36 g/m2 for the first cycle,18 g/m2 for other 4 cycles,The total Ara-C dose was 108 g/m2.Results Seven patients finished all of five cycles of HD Ara-C treatment(one patient was treated for four cycles) and 7 of 8 patients are in continuous complete remission(CCR) for 6 to 76 months,one patient died of bone marrow relapse.No chemotherapy-related death was observed.ConclusionSHDAra-C treatment may be of importance for the disease free survival of-AML children receiving chemotherapy.The regimen seems to be effective and relatively safe,but the efficacy of SHDAra-C still needs to be observed in more patients and the mechanism of the treatment needs to be invest i gated.