环孢素联合化疗逆转急性白血病多药耐药的临床研究

Cyclosporine A combined with chemotherapy in reversing multidrug resistance in patients with acute leukemia

目的:探讨环孢素(cyc losporin A,CsA)联合化疗逆转急性白血病(acute leukem ia,AL)多药耐药(mu ltidrug resistance,MDR)的临床疗效。方法:28例急性白血病患者随机分成逆转组(CsA联合化疗)和对照组(单用化疗),且对16例逆转组患者进行P-糖蛋白(P-gp)测定。结果:逆转组总有效率68.8%,复治患者的完全缓解(CR)7/10,均高于对照组的总有效率(25.0%)和复治患者CR(1/8),差异均有显著性(P<0.05)。结论:CsA联合化疗可以克服白血病细胞的MDR,而且随着白血病细胞P-gp阳性表达率增高,CsA的耐药逆转作用可能会越明显。

Objective：To explore the effect of cyclosporin A（CsA） in reversing multidrug resistance（MDR） in patients with acute leukemia （AL）. Methods：Twenty-eight cases of acute leukemia were randomly divided into therapeutic group （CsA plus chemotherapy） and control group（chemotherapy alone）. The expression of P-glycoprotein （P-gp） was assayed in 16 cases of the therapeutic group. Results：The total effective rate was 68.8% and the complete remission（CR） rate of the patients receiving repetition treatment was 7/10 in the therapeutic group ,while the total effective rate was 25.0% and the CR rate of the patients receiving repetition treatment was 1/8 in the control group. The difference was significant（ P 〈 0.05 ）. Conclusions ： The CsA combined with chemotherapy may reverse MDR in patients with acute leukemia. With the rise of the positive expressing rate of P-gp of the leukemia cells, CsA＇ s reverse effect on MDR is more obvious.