摘要
目的 本文对ALL患儿 13例用小剂量L -asp的用药方法 ,以求达到既能减低或避免副作用的发生 ,又能保证L -asp作用的效果 .方法 对在接受L -asp化疗的ALL患儿 5 9例 195疗程 ,出现L -asp相关副作用后改用小剂量 (常规剂量 1/ 10 )L -asp治疗的 13例 ,观察其副作用发生的情况 .结果 应用常规剂量者有 13例 34例次出现L-asp相关副作用 ,发生率为 17.4 % ,其中 2例因出血性胰腺炎死亡 .改用小剂量L -asp治疗者 13例 4 2个疗程 ,发生L -asp相关副作用者 2例次 ,发生率为 4 .8% ,显著低于应用常规剂量L -asp者 . 6例曾经发生过L -asp严重副作用的患儿在我科持续系统治疗 ,均未再次发生类似或其他L -asp副作用 ,CCR时间为 15 31± 14 0天 ,中位CCR时间为135 8天 .结论 对曾发生L -asp副作用的病例应用小剂量L -asp是安全有效的 .为预防L -asp相关副作用的发生 ,特别是已发生L -asp相关副作用的ALL患儿能继续应用L -asp治疗提供了科学的依据和可行的方法 .
Objective The enzyme L-asparaginase(L-asp)plays an im po rtant role in the induction、remission and long-term disease free survival of ac ute lymphoblastic leukemia patients.But L-asp might induce many serious side eff ects,even increase the chemotherapy related mortality.Therefore there is a hypo thesis :whether the dosage reduction of L-asp can reduce or avoid the incidence of the side effects,as well as the protocol can assure the therapeutic efficacy of L-asp. Methods From Jan.2000 to Apr.2004,59 children with AL L were studied.They were given total 195 L-asp therapy courses in our division.T he dosage of L-asp was switched to one of tenth (1,000 U/m2 per dose) of the usu al dosage for the continuous chemotherapy of the 13 patients who occurred L-asp related side effects and the related side effects were observed carefully. Results During 34 therapy co urses,13 cases among the total 195 usual dosage L-asp therapy courses occured on e or more kinds of L-asp related side effects,incidence was 17.4%.2 cases dead o f hemorrhagic pancreatitis. Among the total 42 low-dose L-asp therapy courses wh om serious L-asp related side effects had occurred before, 2 cases occured L-asp related side effects,incidence was 4.8%.6 patients,every one in whom serious L- asp related side effects had occurred before,did not occur any toxicity after th ey were switched to low-dose L-asp.And so far all of them were in continuous com plete remission(CCR) with average of(1531±140) days and median of 1358 days. Conclusions The results suggested that the administration of lo w-dose L-asp is safe and effective.Even the patients who had occurred side effec ts before can be safely administered low-dose L-asp again.
出处
《现代临床医学生物工程学杂志》
2004年第5期393-395,共3页
Journal of Modern Clinical Medical Bioengineering
