米托蒽醌方案对CD+34高表达急性淋巴细胞白血病的临床疗效观察

目的 探讨米托蒽醌(MTZ)在急性淋巴细胞白血病(ALL)化疗中的作用特点。方法 50例CD34^ 抗原高表达的ALL上，随机选择二种化疗方案(CPMP，CODP)。联合化疗1个疗程后分别比较CR率、骨髓抑制及其他毒副作用；同时将骨髓白血病细胞体外培养72h。进行药物杀伤效应实验。分别比较MTZ、柔红霉素(DNR)在体外对ALL细胞不同分化阶段的抑制作用。结果 CD34抗原高表达的ALL中，以MTZ为主的COMP方案的1个疗程缓解率为92．6％。比CODP方案高27．4％。体外白血病细胞培养加药物抑制试验结果显示，MTZ对分化较早阶段的CD34^ ALL细胞的抑制显著高于DNR。结论 MTZ对ALL具有较强的抗白血病活性，临床骨髓抑制明显。上述特点可能与其主要作用于白血病细胞的分化较早阶段有关。

The clinical studies of mitoxantrone in acute lymphocytic leukemia with high percent of CD+34leukemia cells

Objective To investigate the character of antitumor effects of mitoxantrone (MTZ) and the mechanisms. Methods Patients with expressed CD+34 leukemic cells in high proportion was randomized to receive the MA/MAE, DA/DAE induction chemotherapy regimen and evaluate the efficacy and safety. The killing effects of MTZ were investigated by the culture of the leukemic cells in vitro. Results In COMP achieved 92.6 % (24/27) remission. Higher inhibition to CD+34 cells in vitro in MTZ than DNR. Conclusions MTZ induction therapy produces a significantly better remission rate than do the DNR regimens. There were no significant differences between in cardiac toxicity, or duration of neutropenia and thrombocytopenia.