大剂量阿糖胞苷治疗儿童急性淋巴细胞白血病的疗效观察

目的:观察大剂量阿糖胞苷(Ara-C)治疗儿童急性淋巴细胞白血病(ALL)的临床疗效。方法:选择我院2003年11月-2006年11月收治的50例ALL患者,均分为治疗组和对照组。在常规诱导方案联合化疗达到完全缓解后,治疗组给予HD(H:高三尖杉酯碱;D:柔红霉素)联合大剂量Ara-C巩固治疗,对照组仅给予HD巩固治疗。观察、比较2组的临床疗效,患者化疗结束后1、3、5年内的无病生存率及不良反应。结果:治疗组总有效率为88.0%,显著高于对照组(44.0%),2组比较差异有统计学意义(χ2=4.399,P<0.05);治疗组1、3、5年的无病生存率分别为88.0%、64.0%、32.0%,对照组分别为48.0%、20.0%、0,治疗组均显著高于对照组(χ2分别为4.116、5.439、6.821,P<0.05);2组在治疗过程中均出现不同程度的骨髓抑制和胃肠道反应,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:大剂量Ara-C方案巩固治疗儿童ALL临床疗效及安全性较好,可以显著延长患者的无病生存期。

Efficacy Observation of Large-dose of Cytosine Arabinoside in the Treatment of Children Acute Lymphoblastic Leukemia

OBJECTIVE:To observe the clinical efficacy of large-dose of cytosine arabinoside(Ara-C) in the treatment of children acute lymphoblastic leukemia(ALL).METHODS:50 ALL patients were collected from our hospital during Nov.2003 to Nov.2006 and then divided into treatment group and control group.After the patients achieved complete remission by receiving conventional induction chemotherapy program,the treatment group received consolidation therapy of HD(H means homoharringtonine;D means daunomycin) combined with large-dose of Ara-C,and the control group received consolidation therapy of HD alone.Clinical efficacies of 2 groups were observed and compared,and the disease free survival(DFS) of 2 groups in 1 year,3 years and 5 years after chemotherapy were observed as well as adverse drug reactions.RESULTS:The total effective rate of treatment group was 88.0%,which was significantly higher than that of control group(44.0%),there was statistical significance(χ2=4.399,P<0.05);the DFS of treatment group in 1 year,3 years and 5 years was 88.0%,64.0% and 32.0%,and those of control group were 48.0%,20.0% and 0,respectively.Those of treatment group were all higher than those of control group(χ2=4.116,5.439,6.821,P<0.05);bone marrow suppression and gastrointestinal tract reaction at different degrees were observed in both groups during chemotherapy,but the adverse drug reactions of 2 groups was not statistically significant(P>0.05).CONCLUSION:The consolidation therapy of large-dose of Ara-C has good clinical efficacy and safety in the treatment of pediatric ALL,and can significantly prolong the DFS.