小儿髓外白血病防治方法的研究

A STUDY ON METHODS FOR PREVkNTIONAND TREATMENT OF EXTRAMENT OF EXTRAMEDULLARYLEUKEMIA IN CHILDREN

为降低中枢神经系统白血病（ＣＮＳＬ）和睾丸白血病（ＴＬ）发病率，对１４０例急性白血病恩儿分别采用￣（６０）Ｃｏ头颅照射（￣（６０）Ｃｏ）、大剂量氨甲蝶呤静注（ＨＤＭＴＸ）、￣（６０）Ｃｏ＋ＨＤＭＴＸ、ＨＤＭＴＸ＋￣（６０）Ｃｏ四种方法进行ＣＮＳＬ和ＴＬ防治研究。结果表明：四组防治ＣＮＳＬ的疗效相似，ＣＮＳＬ发生率无显著差异（Ｐ＞０．０５）；急性淋巴细胞白血病早期采用ＨＤＭＴＸ预防ＴＬ效果满意，而￣（６０）Ｃｏ组ＴＬ发生率高。从整体防冶效果评价，ＨＤＭＴＸ静注优于￣（６０）Ｃｏ头颅照射。１２例接受双侧睾丸放疗配合全身化疗，ＴＬ均未发生，３例只接受患侧睾丸放疗配合全身化疗者均发生ＴＬ。提示早期使用ＨＤＭＴＸ，必要时配合￣（６０）Ｃｏ放疗可防止中枢神经系统白血病和睾丸白血病的发生。

or prevention and treatment of central nervoussvstem leukemia(CNSL)and testicular leukemia(TL),140 children with acute leukemia were treatedwith either cranial radiation of cobalt(￣(60)Co ) or highdose methotrexate(HDMTX),or ￣(60) Co/HDMTX,orHDMTX/￣(60)Co.The results Showed that the curativeeffects were similar among these four methods(P<0.05); the early use of intravenous injecton ofHDMTX led to a satisfactory result in preventing TL;patients treated with ￣(6)Co had higher incidence of TLthan those treated with other methods( P<0.01):patients with solitarv CNSL,solitary TL andlate devel-oped TL had better outcome than the cases with CNSLand ( or )TL accompanying bone marrow relapse did。For the general evaluation of curative effects on prevent-ing and treating patients with CNSL , TL and bone mar-row relapse,we found that the intravenous injection ofHDMTX was more effective than cranial radiation with￣(60)Co. The result from treating 15 patients with TLshowed that the combination of bilateral testicular radi-ation and a general chemotherapy was an effective andrational regimen for the treatment of TL。