拓扑替康联合方案治疗恶性血液病的临床研究

Efficacy of Topotecan Combind Therapy in Patients with Malignant Hematopathy

目的 :评价拓扑替康 (TPT)联合方案治疗慢性粒细胞白血病 (CML)急变及骨髓增生异常综合征 (MDS)转变的急性白血病的疗效及不良反应。方法 :采用TPT联合方案治疗CML急变及MDS转变的急性白血病患者 2 8例 ,其疗效与既往应用米托蒽醌联合阿糖胞苷 (MA)方案化疗做自身对照。所有患者接受 1个疗程TPT组成的联合化疗方案 (TPT、环磷酰胺、阿糖胞苷 )后 ,定期检查血细胞记数、骨髓及肝、肾功能等。结果 :2 8例中有 12例达完全缓解 ,3例达部分缓解 ,总有效率为5 3.5 7% ;13例无反应。主要不良反应为骨髓抑制。TPT联合方案疗效优于MA方案 ,不良反应无明显加重。结论 :TPT联合方案对CML急变及MDS转变的急性白血病具有确切疗效。

Objective: To evaluate the antileukemic activity and side effects of topotecan combine therapy in patients with acute transformationphage of chronic myelogenous leukemia and acute leukemia from myelodysplastic syndrome. Methods: 28 patients with chronic myelogenous leukemia acute transformation phage and acute leukemia from myelodysplastic syndrome were treated with topotecan combine therapy, the effect was compared with their former chemotherapy with mitoxantrone and arabinsyi cytosine (MA). Blood cell counting marrow cell and liver and kidney function were observed periodically in all of therapy patients who received one cycle onsisting of topotecan, cyclophosphamide and arabinosyi cytosine. Results: 12 patients achieved complete remission. 3 patients reached partial remission. The total effective rate was 53.57%. 13 patients had no response. The main side effect was myelosuppression.The effect of TPT combined therapy was superior to MA therapy,at the same time,the adverse effect was no more. Conclusion:The topotecan combine therapy has antileukemic effect in patients with chronic myelogenous leukemia acute transformation phage and acute leukemia from myelodysplastic syndrome.