拓扑替康为主联合方案治疗难治性和复发性急性淋巴细胞白血病的临床探讨

目的 探讨以拓扑替康为主的治疗方案对难治及复发性急性淋巴细胞白血病(ALL)的疗效及毒性反应。方法 拓扑替康联合顺铂或异环磷酰胺及阿糖胞苷治疗预后差的难治性及复发性ALL8例。结果 经1个疗程治疗后判断疗效，完全缓解(CR)5例，CR率62．5％；部分缓解(PR)1例，PR率12．5％；未缓解(NR)2例，NR率25％；总有效率75％。不良反应主要表现为白细胞及血小板明显减少的骨髓抑制。结论 拓扑替康对预后不良、难治及复发性ALL具有肯定疗效，是一种很有前途的治疗药物。不良反应主要为骨髓抑制，非血液系统毒性轻微。

Clinical study of the effect of topotecan in combination with chemotherapy on relapsed and refractory acute lymphoblastic leukemia

Objective To evaluate the efficacy of topotecan on relapsed and refractory acute lymphoblastic leukemia(ALL) and its toxicity. Methods 8 cases of relapsed and refractory ALL were treated with topotecan combined with cisplatin or ifosfamide and cytarabine. Results One therapeutic course later,the complete remission rate was 62.5%,the partial remission rate was 12.5% and non response rate was 25%. The total effective rate was 75%. The main adverse effect was myelosuppression characterized by remarkably decreased numbers of white blood cell and platelet. Conclusion Topotecan produces positive efficacy on relapsed and refratory ALL which often bears no better prognosis,and proves to be a prospective medicine for treating ALL. Its main adverse effect is myelosuppression with little toxicity to other systems.