经济型化疗方案治疗儿童急性淋巴细胞白血病18例

Clinical observation of economical chemotherapy for 18 cases of acute lymphoblastic leukemia in childhood

目的 探讨治疗儿童急性淋巴细胞白血病的经济型化疗方案.方法 诱导缓解CODP 4周;用VP16＋Ara-c巩固治疗;髓外白血病的预防性治疗;采用COADex方案早期强化治疗;维持和加强治疗6-MP＋MTX与VDex重复序贯用药;用CO-ADex与VP16（或VM26）＋Ara-c,以及HDMTX＋CF,每3个月交替应用加强治疗.结果 18例ALL初治均达完全缓解（CR率100%）,初治平均住院天数81 d,平均费用2.3万元,维持治疗阶段,平均每年费用6000元左右,18例中8例已完成总疗程,停止治疗.1例在维持治疗阶段因感染水痘致DIC死亡.1例在维持治疗阶段因鞘内注射后出现瘫痪,而放弃治疗.4例已接受完成总疗程,其余4例已维持治疗1～1.5年.目前无复发及髓外白血病发生.结论 此化疗方案治疗儿童急性淋巴细胞白血病的疗效肯定,费用低,副作用少,值得在贫困地区推广应用.

Objective To study the economical chemotherapy for acute lymphoblastie leukemia in ehidhood. Methods ①Induction remission chemotherapy with CODP for 4 weeks. ②The consolidation treatment with VP16 ＋ Ara-c. ③Prophylactic treatment for extramedullary leukemia. ④Early intensification therapy with COADex. ⑤Sustain therapy with 6-MP ＋ MTX or VDex in turn. Per three months gave intensive therapy with COADex or VP16 （ or VM26 ） ＋ Ara-c, added with HDMTX ＋ CF. Results All the 18 cases achieved complete remission, the average hospital days of initial treatment is 81, the average cost is 23 thousand yuan, in sustain stage is about 6000 yuan per year. In the all 18 cases,8 cases had treatment discontinued, one patient died in varicella, and one patient was plaralysed after intrathecal injection,then gave up. 4 cases are near to complete all the course of treatment. The rest 4 cases have been in sustain stage for 1 - 1.5 years. Now all the cases are no recurrence and no extramedullary leukemia. Conclusion The effect of this protocal was confirmed, costs were lower, and side effects were fewer. This protocol are deserved to be spread.