摘要
目的评价米托蒽醌为主的联合化疗方案在儿童初治急性非淋巴细胞性白血病治疗中的疗效与安全性。方法选用1997年7月～2002年5月的儿童初治急性非淋巴细胞性白血病病例,对以米托蒽醌为主的化疗方案组(米托蒽醌组,24例)和以柔红霉素为主的化疗方案组(对照组,11例)之间的疗效及毒副作用进行比较分析。结果诱导治疗1疗程后,米托蒽醌组完全缓解率59.09%,对照组40.00%,米托蒽醌组不缓解率13.64%,对照组30.00%,两组间无统计学意义(P>0.05)。对坚持治疗的病例随访1～5.5a,米托蒽醌组(10例)有2例无病生存超过5a,1例超过2.5a,2例超过1a;对照组(6例)中,1例无病生存超过5a,1例完全缓解4a,但死于扩张性心肌病。随访期间,米托蒽醌组有50.00%复发,对照组有66.70%复发。在诱导缓解期,米托蒽醌组粒细胞缺乏时间长于对照组[(12.2±3.7)dvs(8.1±2.6)d],P<0.01,血小板小于20×109/L的时间亦长于对照组[(8.1±2.6)dvs(6.2±1.6)d],P<0.05。米托蒽醌组并发感染率90.90%,高于对照组50.00%(P<0.05),而心脏毒性发生率明显低于对照组(4.55%vs40.00%)(P<0.05)。恶心呕吐、口腔溃疡、肝功能损害和脱发等毒副反应两组无差异(P>0.05)。结论米托蒽醌为主的联合化疗方案治疗儿童初治急性非淋巴细胞性白血病是安全和有效的。
To evaluate the efficacy and safety of mitoxantrone in newly diagnosed childhood acute non-lymphocytic leukemia. 24 patients with newly diagnosed childhood acute non-lymphocytic leukemia received mitoxantrone and arabinosyl cytosine contained regimen(MA) for induction, Other 11 patients for control received daunorubicin and arabinosyl cytosine contained regimen. The efficacy and side effects were analyzed in two groups. More patients achieved complete remission in MA group after first course of induction (59.09% vs 40.00%), but there was no statistical significance. During 1 to 5.5 years follow-up of the patients who did not give up chemotherapy, 2 cases had disease free survival (DFS) over 5 years, 1 cases over 2.5 years and other 2 cases over 1 year in MA group(10 cases), while 1 case had DFS over 5 years and other one case had survived for 4 years and died of dilated congestive cardiomyopathy in control group (6 cases). The duration of neutropenia was longer in MA group when compared to control [(12.2±3.7) days vs (8.1±2.6) days] (P<0.01), the duration of severe thrombocytopenia (platelet less than 20×109/L) was longer than that in control group too [(8.1±2.6) days vs (6.2±1.6 days)] (P<0.05). There were higher infection rate and lower cardiac toxicity in MA group (90.90% vs 50.00% and 4.55% vs 40.00% respectively) (P>0.05). There were no significant differences between two groups in of early death and degree of organ toxicity except cardiac toxicity and bone marrow suppression. [Conclusion] Mitoxantrone contained regimen is effective and safe in the treatment of childhood acute non-lymphocytic leukemia.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2005年第2期250-252,255,共4页
China Journal of Modern Medicine
