摘要
目的监测急性髓细胞性白血病患儿在大剂量Ara-c化疗后的Ara-c及其代谢物Ara-u的血浆浓度,分析药物代谢的个体差异以及对化疗副反应和长期预后关系。方法采用高效液相色谱法(HPLC)测定Ara-c,Ara-u的血浆浓度,并采集临床资料进行分析。结果大剂量Ara-c化疗时血药高峰浓度平均为(39.46±15.13)μmol/L,Ara-u血浆浓度平均为(258.23±58.23)μmol/L,化疗反应阳性和阴性组Ara-c,Ara-u血浆浓度两组比较P值分别为0.769和0.187,Ara-c血浆浓度与骨髓抑制期天数相关系数0.135,P值0.462。相应Ara-u浓度与骨髓抑制期天数相关系数0.268,P值0.138。化疗后感染组和非感染组Ara-c,Ara-u血浆浓度两组比较P值分别为0.920和0.869,长期生存组和复发组Ara-c,Ara-u血浆浓度两组比较P值分别为0.126和0.723。结论Ara-c,Ara-u血浆浓度存在明显个体差异,但和化疗反应、化疗后骨髓抑制期长短、化疗后感染、无明显相关与患儿的长期预后亦无相关。
Objective To monitor the plasma concentration of cytarabine （Ara-C） and uracil arabinoside （Ara-c） and analyze their correlations to the chemotherapy side effects and prognosis in pediatric acute myeloid leukemia treated with high dose cytarabine. Methods The concentration of Ara-c and its metabolite Ara-c was determined with HPLC, and patients＇ Clinical data were summarized and analyzed. Results The plasma Ara-c reached a peak at 39.46 ± 15.13 μmol/L , The plasma Ara-u reached a peak at 258.23 ± 58.23μmol/L. The P value of the plasma concentration of Ara-c and Ara-u between the 2 groups with or without therapeutic side effects was 0. 769 and 0. 187, respectively. The correlation coefficients of plasma concentration of Ara-c to the period of bone marrow suppression was 0. 135 （P =0. 462）. The correlation coefficients of plasma concentration of Ara-u to the period of bone marrow suppression is 0. 268 （ P = 0. 138 ）. Comparing the plasma concentration of Ara-c and Ara-u between the 2 groups with or without infection, the P values were 0. 920 and 0. 869 respectively. Between the relapse free survival group and relaps group the P values were 0. 126 and 0. 723 respectively. Conclusion The plasma concentration of Ara-c and Ara-u was various among individuals, but had correlation neither to chemotherapy side effects, such as the period of bone marrow suppression and infection, nor to relapse free survival.
出处
《中国小儿血液与肿瘤杂志》
CAS
2008年第6期258-260,共3页
Journal of China Pediatric Blood and Cancer
