摘要
目的观察改良VD（M）CLP和标准VDCLP方案对成人急性淋巴细胞白血病诱导化疗的疗效并进行疗效及毒副作用对比。方法2003年11月至2006年12月本所收治初治成人急性淋巴细胞白血病患者50例，随机分为两组，每组各25例，～组予改良VD（M）CLP：（柔红霉素（DNR）45mg／m^2／d，d1～3；环磷酰胺（CTX）600mg／m^2／d，d1；长春新碱（VCR）2mg，d1、8；强的松（Pred）60mg／m^2／d，d1～14，左旋门冬酰胺酶（L-asp）6000u／m^2／d，d3～12。第15天复查骨穿，评价疗效。如增生减低WBC（1．0×10^9／L，加用G-CSF150μg／d，待血象恢复后再次评价。如仍增生活跃或幼稚细胞比例大于5％，可将DNR换用骨髓抑制作用较强的米托葸醌（MTZ）6mg／m^2／d，d1～3。并再次予以VCP，其剂量及用药时间酌情增减，仍未缓解者改用它方案；一组予标准VDCLP：柔红霉素（DNR）45mg／m^2／d，d1～3，d15～17；环磷酰胺（CTX）600mg／m^2／d，d1、15；长春新碱（VCR）2mg，d1、8，15，22；强的松（Pred）60mg／m^2／d，d1～14，d15开始减量；左旋门冬酰胺酶（L-asp）6000u／m^2／d，d19～28。疗程结束两周或血象恢复查骨穿，评价疗效。结果改良VD（M）CLP方案组完全缓解23例（92％）；VDCLP方案组完全缓解（CR）17例（68％），差异有显著性（P〈0．05）。毒副作用比较：VDCLP方案组感染率高，差异有显著性（P〈0．05）。结论改良VD（M）CLP方案作为成人急性淋巴细胞白血病诱导治疗方案，有效率较高，不良反应较少，初步结果提示其可作为首选方案之一。
Objective This study was designed to improve completely remission（CR） rate in adult patients with acute lymphocytic leukemia by using the modified VDC（M）LP regimen. Methods A total of 50 patients were enrolled and divided into two groups randomly. We treated 25 patients with the modified VDC （M） LP regimen, including DNR 45 mg/m^2/d,d1 - 3; CTX600 mg/m^2/d,d1; VCR 2 mg, d1, 8; Pred60 mg/m^2/d ,d1- 14, L-asp 6000 u/m^2/d ,d3- 12. Bone marrow aspirations were conducted on day 15 after initiation of the chemotherapy. If the leukemicblasts among hone marrow nucleated cells is less than 5 percent, we would replace the DNR with MTZ 6mg/m^2/d,d1-3 and continue using VCR or Pred. As a contrast, the other 25 patients received the routine VDCLP regimen for 4 weeks. Results VDC（M）LP group..23 （92%） achieved complete remission; the infection rate was 60%. In the contrast group, 17 （68%） achieved complete remission and the infection rate was 100%. There was statistic difference in both CR rate and infection rate between two groups （P〈0.05）. Conclusion The modified VDC（M）LP regimen is significantly improve CR rate for ALL patients and this induction regimen was feasible for Chinese patients.
出处
《国际输血及血液学杂志》
CAS
2007年第5期397-399,共3页
International Journal of Blood Transfusion and Hematology
关键词
淋巴细胞白血病
急性
诱导
化疗
lymphocytic leukemia
acute
induction
chemotherapy
