中国实用儿科杂志

中国实用儿科杂志

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大剂量阿糖胞苷短疗程化疗方案在儿童急性淋巴细胞白血病的临床应用总结

左英熹，刘桂兰，陆爱东，王彬，张乐萍   

  1. 北京大学人民医院儿科，北京100044
  • 收稿日期:2006-11-01 修回日期:2007-03-05 出版日期:2007-06-06 发布日期:2007-06-06

Curative effect analysis of high dose cytosine arabinoside in the chemotherapy for childhood acute lymphoblastic leukemia.

ZUO Ying-xi,LIU Gui-lan,LU Ai-dong,et al.   

  1. Department of Pediatrics,People's Hospital,Beijing niversity,Beijing 100044,China
  • Received:2006-11-01 Revised:2007-03-05 Online:2007-06-06 Published:2007-06-06

摘要： 目的总结应用包括大剂量阿糖胞苷(Ara-C)的短疗程化疗方案治疗儿童急性淋巴细胞白血病(ALL)的临床疗效。 方法总结1992-01—2001-07在北京大学人民医院儿科初治并长期随访的ALL患儿84例，其中男52例，女32例，长期无病生存(EFS)5年以上，随访 时间至2006-07。 结果标危型患儿EFS率79.59%，高危型患儿的EFS率为25.81%；长期存活患儿中最长EFS为14年6个月，最短EFS为5年，中位EFS为9年11个月。有6 例发生中枢神经系统白血病。未出现与大剂量Ara-C化疗相关的患儿死亡。 结论(1)采用包括大剂量Ara-C的短疗程化疗方案能够获得较高的完全缓解率及EFS率，且副反应小。(2)采用该短疗程方案不加用颅脑放疗，中 枢神经系统白血病的发生率无提高。(3)ALL患儿对Ara-C的敏感性存在明显的个体差异。

关键词: 急性淋巴细胞白血病, 阿糖胞苷, 化疗

Abstract: AbstractObjectiveTo evaluate the curative effect of a short-peroid protocol on acute lymphoblastic leukemia,which involved high dose cytosine arabinoside (Ara-C) regimen. MethodsThe research included 84 diagnostic patients in our department from January 1992 to July 2001:52 boys and 32 girls.Data collection lasted until July 2006. ResultsAbout 79.59% of the standard-risk patients achieved event-free survival,while only 25.81% of the high-risk patients achieved event-free survival.The median event-free survival of patients was 9 years and 11 months (ranging from 5 years to 14 years and 6 months).Central nervous system leukemia happened in 6 patients.No death was related to high dose Ara-C chemotherapy. Conclusion1.The short period protocol,involving high dose cytosine arabinoside regimen,increases the complete remission rate and event-free survival rate,and has few adverse effects.2.Cranial irradiation isn't performed in this protocol,and no more patients suffer from central nervous system relapse.3.The sensitivity of cytosine arabinoside is eminently different from person to person.

Key words: Cytosine arabinoside (Ara-C), Chemotherapy