不同方法治疗高白细胞急性白血病的疗效分析

目的探讨用白细胞去除术加联合化疗、羟基脲 (HU)加联合化疗及单用联合化疗治疗高白细胞急性白血病(HAL)疗效的差别。方法将 5 3例HAL随机分为 3组 ,HAL 1组和HAL 2组分别先行白细胞去除和口服Hu ,显著降低白细胞后再行联合化疗 ,HAL 3组单用联合化疗 ,观察各组疗效及不良反应。 30例非高白细胞急性白血病 (NHAL)单用联合化疗作为对照组。结果HAL 1组与HAL 2组间完全缓解 (CR)率、早期病死率无显著差异 ,白细胞去除和口服HU无严重不良反应 ,其CR率均显著高于HAL 3组 (P <0 .0 5 ) ,而早期病死率低于后者。结论白细胞去除术及HU口服对降低HAL患者的白细胞是有效、安全的 ,随后行联合化疗可显著提高疗效。

The therapeutic effect of different methods to treat high leukocytic acute leukemia

Objective To study the differences of the therapeutic effect by using three methods(leukapheresis with combination chemotherapy, hydroxyurea(HU) with combination chemotherapy, combination chemotherapy alone) to treat high leukocytic acute leukemia(HAL). Methods 53 patients with HAL were divided into 3 groups randomly. HAL1 group was treated with leukapheresis and HU, respectively, to decrease leukocytes significantly, and then treated with combination chemotherapy. HAL3 group was treated with combination chemotherapy alone. The clinical therapeutic effect and side effect was observed among the three groups. 30 patients with non-high leukocytic acute leukemia(NHAL) treated with combination chemotherapy alone were observed as control group. Results The difference between HAL1 group and HAL2 group in complete remission(CR) rates and early mortality was not statistically significant. During leukapheresis and HU administration, no severe side effect was found. CR rates of the two groups were significantly higher than that of HAL3 grop(P<0.05),meanwhile early mortality of them was lower than that of the latter. ConclusionLeukapheresis and HU administration are effective and safe to decrease leukocytes of HAL patients, and can improve therapeutic effect significantly if followed with combination chemotherapy.